The Skeptics' Guide to EM

SEPTEMBER 11, 2021

The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation. The EKG shows sinus tachycardia with nonspecific changes and no ST segment elevations, Q waves, or hyperacute T waves. The AHA has a statement with recommendations based on the available data.

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EKG/ECG Academics EMS CPR 52

Dr. Smith's ECG Blog

OCTOBER 24, 2013

The physician recorded this ECG, interpreted it as normal, and sent the patient home on an antacid. He underwent immediate CPR, was found to be in ventricular fibrillation, and was successfully resuscitated. I do not have the post-resuscitation ECG. Did the ECG offer unseen hints? See explanation below. Lesson : 1.

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EKG/ECG Resuscitation CPR Ultrasounds 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2019

A prehospital ECG was recorded: Limb leads: Precordial Leads What is the therapy? On arrival, the patient was in shock, was intubated, and had an immediate cardiac ultrasound. What does a heart look like on ultrasound when the EKG looks like that? The followup ECG is here: Now the QRS is only slightly prolonged.

Shock 40

Shock EKG/ECG Resuscitation Ultrasounds 40

Dr. Smith's ECG Blog

JUNE 11, 2021

Jesse McLaren (@ECGcases), of Emergency Medicine Cases Reviewed by Pendell Meyers and Steve Smith An 85yo with a history of hypertension developed chest pain and collapsed, and had bystander CPR. The paramedics found the patient with ROSC and a GCS 7, and an ECG showing LBBB with possible lateral ST elevation. So the RCA was stented.

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EKG/ECG Documentation/Coding CPR Shock 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

Here is his ECG: The resident was alarmed at the "ST elevation in III with reciprocal ST depression in aVL" Are you alarmed? An elderly patient with a ruptured abdominal aortic aneurysm: Formal ECG Interpretation (final read in the chart!) : "Inferior ST elevation, lead III, with reciprocal ST depression in aVL." What do you think?

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EKG/ECG CPR Resuscitation Outcomes 40

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He had the following EKG recorded: Low voltage, suggests effusion. A bedside cardiac ultrasound was normal, with no effusion. He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. He was moderately hypoxic. He was intubated and then went pulseless.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

EB Medicine

MARCH 1, 2019

Again, no standard definition exists, with some diagnostic criteria including simply chest pain and increasing cardiac enzymes, and others including cardiac dysfunction, ecg abnormalities, wall motion abnormalities, and an elevation of cardiac enzymes. New EKG findings requires admission for monitoring. of those patients.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

EB Medicine

NOVEMBER 1, 2018

Thankfully, that gentleman was successfully resuscitated despite no bystander CPR, and if you listen carefully, we hope to arm you with the tools to do so similarly. These aren’t your standard arrest patients though, they typically have many fewer comorbidities – so CPR tends to be more successful. Let’s move on to treatment.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

Dr. Smith's ECG Blog

APRIL 8, 2016

Bedside ultrasound showed no effusion and moderately decreased LV function, with B-lines of pulmonary edema. Here is his ED ECG: There is obvious infero-posterior STEMI. This subsequent ECG was recorded after the K was up to 2.2 These two rhythms are often indistinguishable on the monitor or ECG. This was stented.

Resuscitation 52

Resuscitation EKG/ECG Hospitals Administration 52

EMDocs

JANUARY 11, 2024

Data that do not establish neurological risk stratification in the first 6 hours after CA include the patient’s age, duration of CPR, seizure activity, serum lactate level or pH, Glasgow motor subscore in patients who received NMB or sedation, pupillary function in patients who received atropine, and optic nerve sheath diameter (95.3%, 20/21).

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Seizures Shock Infectious Diseases CPR 94

Critical Care Now

JUNE 21, 2022

His main areas of interest are Critical Care, Ultrasound, Prehospital Resuscitation, and Medical Education. CPR was started immediately after the coaching staff could not find a pulse and EMS arrived to find the patient in cardiac arrest. His coach and fellow players witnessed a seizure-like activity immediately after collapsing.

Seizures 52

Seizures EKG/ECG CPR Shock 52