Dr. Smith's ECG Blog

FEBRUARY 12, 2023

I was reading EKGs on the system before a shift, and saw this one: What do you think? I went to the chart and found that the patient was a sepsis patient with hypotension and a K of 3.0. So I thought it probably is not posterior OMI and I just moved on and kept reading EKGs. So we did a bedside cardiac ultrasound.

EKG/ECG 40

EKG/ECG Sepsis Ultrasounds 40

Dr. Smith's ECG Blog

MAY 19, 2020

A followup ECG was recorded 2 days later: No definite evidence of infarction. The ways to tell for certain include intravascular ultrasound (to look for extra-luminal plaque with rupture) or "optical coherence tomography," something I am entirely unfamiliar with. pulmonary embolism, sepsis, etc.), myocarditis). Did YOU see them?

CPR 52

CPR EKG/ECG Shock Ultrasounds 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

What is your ECG interpretation and what would you do next? This ECG shows a normal sinus rhythm with a normal conduction pattern (normal PR, normal QRS, and normal QTc), normal axis, late R wave progression (and misplaced V2), normal voltages, ST-elevation in aVR and global ST-depressions. BP was 110 and oxygen saturation was normal.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 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

Mind The Bleep

DECEMBER 31, 2023

or the patient is symptomatic or shows signs of hypokalaemia (ECG changes, weakness, arrhythmias). Acutely, the first step is to ensure there are no ECG changes caused by low calcium. These require swabs, antibiotics, potentially a sepsis screen and bleeping your registrar / consultant for further advice.

Fluid Resuscitation 52

Fluid Resuscitation Hospitals Sepsis EKG/ECG 52

Taming the SRU

JUNE 26, 2024

Patients with AML and sepsis have a higher mortality than their otherwise healthy counterparts. Gut translocation is a common etiology of sepsis in patients with AML. Gram positive sepsis is more common, but gram negative sepsis carries higher morbidity/mortality.

Blood Transfusions 88

Blood Transfusions Sepsis CPR EKG/ECG 88

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

EB Medicine

NOVEMBER 1, 2018

Jeff: And unlike past issues covering more common pathologies, like, say, sepsis, this month’s team reviewed much more literature than just the past 10 years. Jeff: Next, make sure that all patients with high voltage injuries have an EKG and continuous cardiac monitoring. In total, they pulled references from 1966 until 2018.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

EMDocs

OCTOBER 8, 2024

The full differential diagnosis of sinus tachycardia in isolation is extensive ranging from benign etiologies such as anxiety to severely life threatening etiologies such as sepsis. Glucose POC ECG: Is this actually sinus tachycardia? Looking at the initial or even repeating the ECG will be helpful here. Do they have edema?

Shock 106

Shock Emergency Department Pediatrics EKG/ECG 106

EB Medicine

JUNE 6, 2019

CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. Nachi: Diagnosis of appendicitis, in a pregnant patient, ultrasound vs. mri. was sensitive for 28-day mortality in sepsis. Jeff: Indeed. Sounds familiar. Jeff: We sure did!

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

Taming the SRU

MAY 1, 2023

Patients must have EKG findings and meet one of a few other criteria (ie family history of sudden death, VF or VT episode, syncope, nocturnal agonal respirations) Most common in patients of Southeast Asian descent and the mean age of death from arrhythmia if untreated is in the 4th decade of life.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Seizures Emergency Department 52

EMDocs

OCTOBER 29, 2024

Critical Care Ultrasound in Shock: A Comprehensive Review of Ultrasound Protocol for Hemodynamic Assessment in the Intensive Care Unit. m/s)—problematic and elevated > 50 mm Hg (2.5 m/s)—problematic and elevated > 50 mm Hg (2.5 m/s)—problematic and elevated > 50 mm Hg (2.5 m/s)—problematic and elevated > 50 mm Hg (2.5

Shock 98

Shock EMS Sepsis Resuscitation 98

Dr. Smith's ECG Blog

DECEMBER 23, 2024

She was resuscitated and admitted to ICU for presumed sepsis. Hint: What does the arterial waveform correspond to on the ECG? And you can see a sharp deflection in the ECG from pacing artifact. If you do not have an arterial line, use bedside ultrasound to verify myocardial contractility corresponds to pacing.

EKG/ECG 113

EKG/ECG Shock Ultrasounds Sepsis 113

Don't Forget the Bubbles

FEBRUARY 5, 2024

Role of diagnostic tests for sepsis in children: a review. Assessing fluid responsiveness with ultrasound in the neonatal intensive care setting: the mini-fluid challenge. Does ECG monitoring affect resuscitation for neonates with pulseless electrical activity in the delivery room? Anagnostou A, et al. Arch Dis Child.

Pediatrics 52

Pediatrics Research Resuscitation Psychiatric 52

Taming the SRU

AUGUST 25, 2023

wrist in extension clavicle tibial pediatric forearm Most likely injuries to need an x-ray? 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

Seizures 76

Seizures Fractures EKG/ECG Resuscitation 76

Mind The Bleep

NOVEMBER 2, 2024

Request an ECG for the baby if ANY murmur is identified. You are also looking for any other abnormal axis (an ECG should have a rightward axis in a newborn baby up until they are 7 days old when it changes to normal), any arrhythmias, any signs of ventricular strain. Undo the nappy of the baby and palpate the Femoral pulses.

Dislocations 52

Dislocations Documentation/Coding Ultrasounds Wellness 52