Dr. Smith's ECG Blog

AUGUST 13, 2020

Because of the tachcardia, I would expect her to be very poor left ventricular function and maybe Cardiogenic shock. Then I looked into the patient's chart and found an old EKG: This shows a previous QR-wave in V2, diagnostic of old anterior MI. I wrote back: "I am looking at his old EKG. Looks like atrial fibrillation.

EKG/ECG 52

EKG/ECG Shock Stroke Seizures 52

Taming the SRU

JULY 31, 2024

Barometric pressure, humidity, and temperature changes may influence stroke and fall incidence (especially in elderly patients with cardiovascular risk factors). Nice people are not more likely to get cancer. Black clouds don’t exist (but I still sort of think they do).

EKG/ECG 52

EKG/ECG Sepsis Documentation/Coding Stroke 52

Dr. Smith's ECG Blog

OCTOBER 7, 2019

When the physicians approached him, he was ashen, diaphoretic, and appeared in shock. When the paramedics arrived, they obtained a 12 lead ECG and confirmed the unstable vital signs. EKG is pictured below: What do you think? Why is the patient in shock? He was in profound cardiogenic shock.

Seizures 40

Seizures EKG/ECG Shock EMS 40

Taming the SRU

NOVEMBER 29, 2023

Workup with a negative troponin and EKG reliably rules out BCI. Hemorrhagic shock is the most common etiology of instability in trauma and should always be highest on the differential. Posterior circulation stroke Patients with posterior strokes will likely have a low NIH. Ambulation is key during physical exam.

Stroke 53

Stroke EKG/ECG Resuscitation Shock 53

Dr. Smith's ECG Blog

MARCH 15, 2023

Here is her EKG: What is unusual about this? Here is the ECG after ibutilide: What do you notice? Here is the post-cardioversion ECG: Sinus rhythm, still with the longer QT interval. We designed a step-up protocol in which shocks at 50, 100, 200, 300, and 360 J were used for transthoracic cardioversion.

EKG/ECG 52

EKG/ECG Dehydration Stroke Wellness 52

EB Medicine

JANUARY 10, 2020

Show More v Please click here and take our listener survey Part 1: Definitions Myocardial Infarction: elevated cardiac biomarkers (aka troponin) with clinical evidence of acute myocardial ischemia (aka signs and symptoms, ECG changes, abnormal imaging, or coronary thrombosis at cath or autopsy). Diagnostics Telemetry ECG.

Emergency Department 40

Emergency Department Shock EKG/ECG Sepsis 40

The Skeptics' Guide to EM

SEPTEMBER 21, 2019

His ECG shows atrial fibrillation with a rapid ventricular response. SGEM#88 : Shock Through the Heart (Ottawa Aggressive Atrial Fibrillation Protocol) * SGEM#133 : Just Beat It (Atrial Fibrillation) with Diltiazem or Metoprolol? His past medical history is significant for hypertension for which he takes perindopril.

Emergency Department 52

Emergency Department Stroke Academics Shock 52

Dr. Smith's ECG Blog

JANUARY 5, 2020

Here is the ECG: What do you think? A study of 2298 ECGs from 1085 patients which had a computerized interpretation of AF found that in 442 (19%) of these ECGs, from 382 patients (35%), the interpretation was incorrect, and that, in 92 of these 382 patients, the physician had failed to correct it. Among, 2447 ECGs, Mant et al.

EKG/ECG 52

EKG/ECG COPD Wellness Sepsis 52

EB Medicine

NOVEMBER 1, 2018

Nachi: Each year, in the US, approximately 10,000 patients present with electrical burns or shocks. Pay attention to the entry and exit sites, as the pathway of the shock is predictive of the potential for myocardial injury and arrhythmia. Those with low voltage injuries and a normal EKG do not require monitoring.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

Dr. Smith's ECG Blog

AUGUST 3, 2018

Here was his prehospital ECG, which I viewed immediately while the resident performed cardiac ultrasound: What do you think? Here is the cardiac ultrasound which the resident performed as I viewed the ECG: This shows a huge pericardial effusion. An ED ECG was recorded: What do you think? Fluids were started. Is is sinus?

EKG/ECG 40

EKG/ECG Ultrasounds Stroke Shock 40

Taming the SRU

APRIL 13, 2023

stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e. Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Taming the SRU

MAY 1, 2023

Exertional Hyperthermia Patients with heat stroke will present with Temp > 104, AMS, or seizures. EMS was bagging him on arrival Primary notable for Compromised Airway Protection, bilateral Breath sounds, strong pulses,GCS 3 CT images of Head, Chest, Abdomen, Pelvis, and Spine No acute findings pH of 6.75

Poisoning 52

Poisoning Hyperthermia / Hypothermia Emergency Department Seizures 52

Pediatric Emergency Playbook

JUNE 1, 2017

Electrocardiography (ECG) should be performed on any patient with significant blunt chest injury. A negative ECG is highly consistent with no significant blunt myocardial injury. Any patient with a new abnormality on ECG (dysrhythmia, heart block, or signs of ischemia) should be admitted for continuous ECG monitoring.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

EB Medicine

AUGUST 1, 2018

Jeff: There are a shocking 22 million past-month users of marijuana in the US, followed by pain relievers at 3.8 First up is the link between cannabis use and stroke or TIA. times higher risk of stroke or TIA. Jeff: For any patient arriving with suspected cannabis or synthetic abuse, consider checking an EKG.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EMDocs

DECEMBER 16, 2023

A 12-lead EKG shows sinus tachycardia but is otherwise normal. Both can result in heat exhaustion and heat stroke and have many overlapping symptoms. Patients with heat stroke have hot, dry skin and altered mental status (e.g., C, and heat stroke occurs at a core temperature > 40°C. Temps greater than 41.5C

Hyperthermia / Hypothermia 94

Hyperthermia / Hypothermia EMS Stroke Seizures 94

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

Sensible Medicine

JANUARY 20, 2025

After initiation of stroke prevention regimens—often with oral anticoagulation.) The first primary endpoint was a composite of CV death, stroke, hospitalization for heart failure or acute coronary syndrome. They transmitted single-lead ECGs twice per week or when symptomatic. Stroke was even lower at 0.6%

Stroke 59

Stroke Outcomes Hospitals Shock 59

ACEP Now

MARCH 5, 2025

A repeat bedside ECG showed complete resolution of tamponade findings (Figure 2), no appreciable pericardial effusion, and relocation of the heart to typical anatomic location. Figure 2. (A) In normal physiology, inspiration leads to increased negative intrathoracic pressure, allowing for increased preload of both ventricles.

Ultrasounds 52

Ultrasounds Resuscitation Shock Stroke 52