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An undergraduate who is an EKG tech sees something. The computer calls it completely normal. How about the physicians?

Dr. Smith's ECG Blog

This was sent by an undergraduate (not yet in medical school, but applying now) who works as an ED technician (records all EKGs, helps with procedures, takes vital signs) and who reads this blog regularly. The undergraduate's analysis: This EKG shows J point elevation of about 0.5-1 Edited by Smith He also sent me this great case.

EKG/ECG 127
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Another deadly triage ECG missed, and the waiting patient leaves before being seen. What is this nearly pathognomonic ECG?

Dr. Smith's ECG Blog

Pain improved to 1/10 after EMS administers 324 mg aspirin and the following EKG is obtained at triage. If this EKG were handed to you to screen from triage without any clinical information, what would you think? Do you appreciate any dynamic changes compared to the patient’s prior EKG? What do you think? In fact, Kosuge et al.

EKG/ECG 140
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Chest pain, resolved. Does it need emergent cath lab activation (some controversy here)? And much much more.

Dr. Smith's ECG Blog

EKG from triage: Here is his previous ECG: Normal ST Elevation Resident's interpretation: Reperfusion pattern/Wellens' with biphasic T waves in V2 and V3, and in comparison to an EKG in 2020 this is new. Bedside ultrasound with no apparent wall motion abnormalities, no pericardial effusion, no right heart strain.

EKG/ECG 119
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Dr. Elsburgh Clarke Was Among First to Specialize in Emergency Medicine

ACEP Now

1 Just one year prior, Dr. Clarke had begun an emergency medicine residency at what was then known as LA CountyUSC Hospital, Los Angeles. Firsthand Account An ambulance bay at the LA County-USC Hospital in 1978. Dr. Clarke was then hired as assistant director in the emergency department (ED) at Pomona Valley Hospital, Pomona, Calif.

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Acute Dyspnea and Right Bundle Branch Block

Dr. Smith's ECG Blog

I was texted this ECG just as I was getting into bed. Ken (below) is appropriately worried about pulmonary embolism from the ECG. What I had not told him before he made that judgement is that the patient also had ultrasound B-lines of pulmonary edema. Figure-1: I've labeled the initial ECG in today's case.

EKG/ECG 126
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Wide Complex Tachycardia -- VT, SVT, or A Fib with RVR? If SVT, is it AVNRT or AVRT?

Dr. Smith's ECG Blog

Bedside ultrasound showed volume depletion and no pulmonary edema. Here is the prehospital ECG: First ED ECG What do you think? But I changed my mind after seeing the old ECG (below) I later sent it to Ken Grauer, who annotated as below with the red Xs: The "Y" in lead II across the bottom appears to be a PVC.

EKG/ECG 130
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A Comprehensive Guide to Surgical Clerking

Mind The Bleep

An ECG will also help with anaesthetic planning Bloods: CRP, U&E, FBC, LFTs, INR (if on warfarin), VBG (for lactate, pH and glucose), amylase Group and save: not all surgical procedures need group and saves- these are expensive and in many cases, unnecessary- check first!