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Found comatose with prehospital ECG showing "bigeminal PVCs" and "Tachycardia at a rate of 156"

Dr. Smith's ECG Blog

Prehospital EKG and strips (not shown) had "heart rate 156" (according to the computer interpretation) and "Bigeminal PVCs" The prehospital 12-lead looked just like the first ED ECG: What do you think? This ECG is pathognomonic for severe hyperK, and the long ST segment is all but pathognomonic for hypocalcemia.

EKG/ECG 52
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Grand Rounds Recap 11.8.23

Taming the SRU

The time from diagnosis to treatment does not affect outcomes in patients with AML. Abdominal pain, nausea, vomiting, and dehydration are common. Chelation is reserved for cases of end-organ damage or life threats, but should be initiated as quickly as possible to be most effective.

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emDOCs Podcast – Episode 100: Acute Chest Syndrome Part 1

EMDocs

Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis Sickling leads to vascular occlusion, end-organ ischemia, and decreased RBC lifespan, which, in turn, leads to pain crisis, acute anemia, sequestration, infection, and acute chest syndrome (ACS.) ECG: Evaluate for ischemia, right heart strain.

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emDOCs Podcast – Episode 101: Acute Chest Syndrome Part 2

EMDocs

Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis. ECG: Evaluate for ischemia, right heart strain. Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Causes and outcomes of the acute chest syndrome in sickle cell disease. times maintenance.

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Medical Malpractice Insights: A Rare Presentation – Groin pain? Nec fasc? Diabetes? Appendicitis?

EMDocs

EKG shows atrial fibrillation with a rate of 169. She had no persistent vomiting, was not dehydrated and had no fever. A delay in antibiotics administration was unfortunate but no one can say on a “more probable than not” basis that earlier treatment would have changed the outcome. Glucose is 490, CO2 8, and pH 7.26

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Wide Complex Tachycardia. What is the Diagnosis?

Dr. Smith's ECG Blog

On arrival, here is his initial ED ECG, and is identical to the prehospital ECG and at the same rate: There is a regular, wide complex. The patient ' s baseline ECG looks exactly the same, except that it is slower (93) and the p-waves are obvious. Maybe the patient has dehydration, sepsis, hemorrhage, or PE.

EKG/ECG 52
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Syncope and Atrial fibrillation in a Healthy 70-something Male

Dr. Smith's ECG Blog

Here is his ECG: Atrial Fib with a Ventricular Response of about 66. On reading the note the next day, the inpatient admitting team gave an assessment of "dehydration" and was about to discharge the patient. Syncope without prodrome is a significant risk factor for cardiac syncope and poor outcome.