Dr. Smith's ECG Blog

NOVEMBER 19, 2016

An immediate 12-lead EKG was obtained: There is ST elevation in leads aVR and V1, with marked ST depression in I, II, III, aVF, V3-V6. Clinical Course The paramedic activated a “Code STEMI” alert and transported the patient nearly 50 miles to the closest tertiary medical center. What should be done? Should the cath lab be activated?

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

Dr. Smith's ECG Blog

APRIL 15, 2019

A prehospital ECG was recorded (not shown and not seen by me) which was worrisome for STEMI. Here was his initial ED ECG: There is sinus tachycardia at a rate of about 140 There is profound ST Elevation across all precordial leads, as well as I and aVL. A near 60 year old male called 911 for increasingly severe fever and SOB.

EKG/ECG 40

EKG/ECG Sepsis Documentation/Coding Shock 40

Dr. Smith's ECG Blog

JANUARY 5, 2020

Here is the ECG: What do you think? See below how this has been documented. Shah and Rubin studied the computer rhythm interpretation of 2160 12-lead ECGs, compared to 2 cardiologists [ 18 ]. noted computer over-interpretation (false positives) of AF in 9 to 19% of ECGs [ 19 ]. Among, 2447 ECGs, Mant et al.

EKG/ECG 52

EKG/ECG COPD Wellness Sepsis 52

RebelEM

MARCH 9, 2023

Pain / Additional Complaints : Alcohol can weaken the immune system with only moderate use, predisposing individuals to pneumonia, soft tissue infections, and sepsis. Document at each reassessment and always have a low threshold to add on a CTH or labs if the patient is not progressing appropriately.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

EB Medicine

JULY 8, 2019

Leakage from the staple line typically presents within the first week, but can present up to 35 days, usually with fevers, tachycardia, abdominal pain, nausea, vomiting sepsis, or peritonitis. Some may present with isolated tachycardia while others may present with profound sepsis – tachycardia, hypotension, and fever. At 6 to 8 mL/kg.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Dr. Smith's ECG Blog

JULY 21, 2024

The below ECG was recorded. The ECG shows obvious STEMI(+) OMI due to probable proximal LAD occlusion. This ECG does not have the typical ST-vector of an LAD occlusion. See below for Ken Grauer Comment on the initial ECG: == On arrival, another ECG was recorded: There appears to have been quite a bit of spontaneous reperfusion!

EKG/ECG 130

EKG/ECG Shock Hospitals Sepsis 130

EMDocs

OCTOBER 10, 2024

Exam is normal except for tenderness as documented in the diagram. EKG shows atrial fibrillation with a rate of 169. Sepsis is diagnosed and antibiotics started for the first time. High level amputation is considered, but she dies of sepsis and multiorgan failure on hospital day 7. I just failed to document it.

Documentation/Coding 97

Documentation/Coding Hospitals Sepsis Infectious Diseases 97

EB Medicine

JUNE 6, 2019

However, it can also be due to hypoxia, sepsis, anemia, PE, or metabolic acidosis, so consider all of those also in your differential. was sensitive for 28-day mortality in sepsis. Jeff: Speaking of HR, tachycardia can be a response to pain, anxiety, fever, blood loss, or sepsis. An EKG and troponin should be considered.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

Dr. Smith's ECG Blog

DECEMBER 27, 2024

His clinic ECG is shown. In an elderly patient complaining of palpitations, we have an ECG with heart rate 140 bpm. Repeat ECG obtained in ER: Fortunately for the patient, his ventricular tachycardia spontaneously resolved. The current ECG shows sinus tachycardia with old inferior infarct. What do you think?

EKG/ECG 120

EKG/ECG Hospitals Sepsis Documentation/Coding 120

Taming the SRU

FEBRUARY 3, 2025

Initial work up when suspicious of this process should include ECG, chest x-ray, urinalysis, and the following labs: CBC, CMP, magnesium, phosphate, calcium, uric acid, VBG (for pH), and lactate dehydrogenase (10). Therefore, it should only be administered in life-threatening arrhythmia and not simply for peaked t waves on ECG (2,20).

Fluid Resuscitation 56

Fluid Resuscitation Seizures Dehydration Emergency Department 56

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 65

Documentation/Coding Seizures Psychiatric Wellness 65

Mind The Bleep

NOVEMBER 2, 2024

Bruising- this can be common after a vaginal or instrumental birth or in babies who are large for gestational age, and should be documented carefully. The uvula can be difficult to visualise at times so document carefully that the palate has not been fully examined so that the GP can have a close look at the 6-8 week check.

Dislocations 52

Dislocations Documentation/Coding Ultrasounds Wellness 52