Remove EKG/ECG Remove Hyperthermia / Hypothermia Remove Shock
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Should we activate the cath lab? A Quiz on 5 Cases.

Dr. Smith's ECG Blog

Triage is backed up, and 10 minutes into your shift one of the ED nurses brings your several ECG s that has not been overread by a physician. ECG#1 ECG#2 ECG#3 ECG#4 ECG#5 See outcomes of all 5 below, with the Queen of Hearts AI Bot interpretation. (THE True Positive ECG#2 : Also sinus rhythm.

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ToxCard: Second Generation Antipsychotic Overdose

EMDocs

1,2 Neuroleptic malignant syndrome (NMS) (hyperthermia, autonomic instability, rigidity, altered mental status [AMS]) can occur as well and is most often seen with clozapine but has been observed with other atypicals. Rigidity and hyperthermia should raise concerns for NMS. 1 Seizures may occur due to lowered seizure threshold.

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ECG Pointers: Recurrent and Refractory Torsades de Pointes

EMDocs

An ECG is performed and is shown below: Figure 1. Adapted from Dr. Smith’s EKG Blog. Another ECG is obtained and shown below. Source: [link] As you are calling the ICU and cardiology team, the patient has recurrence of her symptoms and repeat ECG shows return of the PVT. She denies chest pain. What do you do?

EKG/ECG 72
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SGEM#391: Is it Time for a Cool Change (Hypothermia After In-Hospital Cardiac Arrest)?

The Skeptics' Guide to EM

You are tidying your things […] The post SGEM#391: Is it Time for a Cool Change (Hypothermia After In-Hospital Cardiac Arrest)? The patient is in ventricular fibrillation, and you achieve return of spontaneous circulation (ROSC) on the second shock. A post-arrest ECG doesn’t show any signs of STEMI. It was also not blinded.

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A 53 yo woman with cardiogenic shock. Believe me, this is not what you think.

Dr. Smith's ECG Blog

A previously healthy 53 yo woman was transferred to a receiving hospital in cardiogenic shock. Here was the ECG: There is sinus tachycardia. Referring to Figure-1 — this 53-year old woman who presented in extremis with cardiogenic shock and an initial pH = 6.9, This was sent by a reader. and K was normal.

Shock 52
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Cardiac Arrest, Ventricular Fibrillation, Inferior and Right ventricular MI (RVMI) or "Pseudoanteroseptal MI"

Dr. Smith's ECG Blog

She arrived comatose and in cardiogenic shock and the following ECG was recorded. That this is an RVMI is confirmed with the following right sided ECG: Now it can be seen that most of the precordial ST elevation is in V4R, much more than is present on the left side of the heart (V1R, which is equivalent to V2 on the left sided ECG.

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2023 AHA Update on ACLS

EMDocs

Emergent coronary angiography is not recommended over a delayed or selective strategy in patients with ROSC after cardiac arrest in the absence of ST-segment elevation, shock, electrical instability, signs of significant myocardial damage, and ongoing ischemia (Level 3: no benefit). o C recommended (Level 1: strong). COR 2a, LOE B-NR.