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ECG Blog #436 — Bigeminy or Alternans?

Ken Grauer, MD

The ECG in Figure-1 — was obtained from an older man with known coronary disease. He developed cardiac arrest shortly after the ECG in Figure-1 was recorded. QUESTIONS: How would YOU interpret the ECG in Figure-1 ? QUESTIONS: How would YOU interpret the ECG in Figure-1 ? Figure-1: The initial ECG in today's case. (

EKG/ECG 404
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Alkali Exposure

EB Medicine

Eckler, MD discuss the January 2025 Emergency Medicine Practice article, Alkali Exposure: An Evidence-Based Approach to Diagnosis and Treatment Patient Demographics and Case Scenarios: Types of patients prone to alkali exposure Causes and scenarios leading to alkali exposure (e.g.,

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EM Quick Hits 57 – HIV Diagnosis, Failed Paradigm of STEMI Criteria, Poisoned Patient Airway Management, Spontaneous Bacterial Peritonitis, DIY Investments

Emergency Medicine Cases

To support EM Cases, please consider a donation here: [link] The post EM Quick Hits 57 – HIV Diagnosis, Failed Paradigm of STEMI Criteria, Poisoned Patient Airway Management, Spontaneous Bacterial Peritonitis, DIY Investments appeared first on Emergency Medicine Cases.

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ToxCard: Bupropion

EMDocs

3 Always get an EKG to assess for cardiotoxicity, including widened QRS and prolonged QTc, although this may not be evident right away. 3 Cardiotoxicity 3 All patients need an EKG and cardiac monitoring. 6,15 Discuss cases of overdose, including pediatric exploratory ingestions, with a medical toxicologist or your local poison center.

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ToxCard: Benzonatate

EMDocs

She received cardiopulmonary resuscitation (CPR) and standard advanced cardiovascular life support (ACLS). She had return of spontaneous resuscitation (ROSC) and was subsequently intubated and transported to the emergency department (ED). Her electrocardiogram (ECG) showed atrial fibrillation which was cardioverted to sinus rhythm.

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Chemical Burns

Mind The Bleep

Circulation Assess heart rate, blood pressure, peripheral and central CRT, pulses and 3 lead ECG. Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% National Poisons Information Service (0344 892 0111) and TOXBASE have useful information on special chemicals and are accessible 24/7.

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Beyond the Burns: Toxic House Fire Gases

Northwestern EM Blog

The post goes into detail on the pathophysiology, signs, symptoms, and diagnosis of both carbon monoxide and cyanide poisonings, so this commentary will focus on the clinical approach. An elevated lactic acid is a surrogate for cyanide poisoning, specifically a level of 8-10 mmol/L or greater is sensitive and should prompt intervention.

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