Dr. Smith's ECG Blog

OCTOBER 26, 2010

He had this ECG recorded. He was rushed by residents into our critical care room with a diagnosis of STEMI, and they handed me this ECG: There is sinus tachycardia with ST elevation in II, III, and aVF, as well as V4-V6. But, remember, we do not evaluate and treat ECGs, we evaluate and treat patients. The K returned at 6.9

EKG/ECG 52

EKG/ECG Dehydration Fluid Resuscitation Sepsis 52

EMDocs

MAY 15, 2024

ECG: Evaluate for ischemia, right heart strain. Ultrasound Sensitivity 88-100%, specificity 68-94% Positive likelihood ratio of 14.6 (95% Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Overestimates arterial oxygen saturation. Up to 3x less accurate in black patients.

Blood Transfusions 78

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 78

EMDocs

MAY 28, 2024

ECG: Evaluate for ischemia, right heart strain. Ultrasound Sensitivity 88-100%, specificity 68-94% LR+ of 14.6 (95% Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. If euvolemic – start maintenance fluids of D5 in 0.45%NS Overestimates arterial oxygen saturation.

Blood Transfusions 75

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 75

ACEP Now

OCTOBER 9, 2024

However, the persistence of tachycardia despite fluid resuscitation and dosing with lorazepam to help with his panic disorder raised concerns that warranted further investigation. Collaborating with one of my ultrasound faculty, we conducted a bedside echocardiogram to explore potential cardiac anomalies. 2012;41(6):1260-1270.

EKG/ECG 52

EKG/ECG Fluid Resuscitation Ultrasounds Outcomes 52

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. Smith comment: This patient did not have a bedside ultrasound. In addition, the patient received 750 mL of fluid resuscitation with transient improvement of blood pressure.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

Taming the SRU

AUGUST 25, 2023

bicarb <18mEq/L) ketosis (preferably serum beta-hydroxybutyrate >3mmol/L) Risk factors SGLT2 inhibitor use fasting state ketogenic diet intra-abdominal pathology (AGE, pancreatitis, etc.) to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1 1 mcg/kg over 10 minutes followed by continuous infusion: 0.2

Seizures 75

Seizures Fractures EKG/ECG Resuscitation 75

ACEP Now

OCTOBER 29, 2024

In such cases, would you wait for a lactate, white blood cell count, bandemia, or other diagnostics to confirm a source of infection before starting antibiotics, fluid resuscitation, and/or pressors? In this study, clinical gestalt is not only fast, but accurate for the benefit of timely resuscitation and intervention.

Emergency Department 59

Emergency Department Mass Casualty Incidents Documentation/Coding Sepsis 59