Dr. Smith's ECG Blog

OCTOBER 28, 2023

Here is his ECG. See this articles: Heart Failure with Preserved Ejection Fraction (NEJM review) One etiology of LVH on the ECG is Hypertrophic Cardiolmyopathy (HOCM), and sometimes ECGs in patients with HOCM are specific for HOCM. But this ECG is NOT specific for HOCM. Figure-1: The ECG in today's case.

EKG/ECG 61

EKG/ECG Stroke Ultrasounds Wellness 61

Dr. Smith's ECG Blog

NOVEMBER 15, 2023

She has no previous cardiac history of which she is aware 911 was called and here is her Prehospital ECG: What do you think? link] Case continued She arrived in the ED and here is the first ED ECG. In comparison with the first ECG, I would guess that the artery is reperfusing. Stroke-volume:50 ml. Normal wall thickness.

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EKG/ECG Ultrasounds Wellness Stroke 108

Dr. Smith's ECG Blog

APRIL 26, 2017

Note 2 other similar cases at the bottom that come from my book, The ECG in Acute MI. Case While I was busy seeing patients, a resident brought me this ECG of a 60-something with a history of syncope only. There was no chest pain or SOB at the tim of the ECG: Computerized QTc is 464 ms A previous ECG from 8 years prior was normal.

EKG/ECG 52

EKG/ECG Ultrasounds Dehydration Stroke 52

EMDocs

MAY 15, 2024

ECG: Evaluate for ischemia, right heart strain. Ultrasound Sensitivity 88-100%, specificity 68-94% Positive likelihood ratio of 14.6 (95% Markers for severe disease include hypoxemia, increasing respiratory rate or work of breathing, decreasing platelet count and/or Hb, and multilobar involvement on chest radiograph or lung ultrasound.

Blood Transfusions 78

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 78

Taming the SRU

JUNE 3, 2024

Susan Wilcox Increasing regionalization due to: Growth of specialty centers Increasing development of healthcare systems Hub-and-spoke models Development of ECMO, trauma, transplant, and stroke centers The higher the acuity of the centers, the higher the acuity of the patient that needs to get there.

Shock 91

Shock Seizures Airway Management Stroke 91

Taming the SRU

AUGUST 4, 2024

In select patient populations (such as those with poor outpatient follow-up), screening with a BMP to evaluate their serum creatinine may be beneficial Patients with asymptomatic hypertension should be referred to their PCP for outpatient follow-up.

Emergency Department 85

Emergency Department Dislocations Documentation/Coding Burns 85

EMDocs

MAY 28, 2024

ECG: Evaluate for ischemia, right heart strain. Ultrasound Sensitivity 88-100%, specificity 68-94% LR+ of 14.6 (95% Markers for severe disease include hypoxemia, increasing respiratory rate or work of breathing, decreasing platelet count and/or Hb, and multilobar involvement on chest radiograph or lung ultrasound. pneumoniae, C.

Blood Transfusions 75

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 75

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 75

Seizures Fractures EKG/ECG Resuscitation 75

Dr. Smith's ECG Blog

MARCH 15, 2023

Here is her EKG: What is unusual about this? Her bedside cardiac ultrasound was normal We decided to cardiovert her since the time of onset was very recent. Here is the ECG after ibutilide: What do you notice? Here is the post-cardioversion ECG: Sinus rhythm, still with the longer QT interval. She was on no medications.

EKG/ECG 52

EKG/ECG Dehydration Stroke Wellness 52

ACEP Now

OCTOBER 29, 2024

Does that normal troponin and ECG obviate the need for cardiology consultation for my patient with a concerning story for acute coronary syndrome? The “bundling” heuristic—if I send a troponin, then an ECG is needed. A testicular ultrasound confirmed restored blood flow. Urology took him for orchiopexy.

Emergency Department 59

Emergency Department Mass Casualty Incidents Documentation/Coding Sepsis 59

Dr. Smith's ECG Blog

OCTOBER 7, 2019

When the paramedics arrived, they obtained a 12 lead ECG and confirmed the unstable vital signs. EKG is pictured below: What do you think? Although the shock is no doubt partly a result of poor pump function, with low stroke volume, especially of the RV, it should be compensated for by tachycardia. Why is the patient in shock?

Seizures 40

Seizures EKG/ECG Shock EMS 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? Is is sinus?

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EKG/ECG Ultrasounds Stroke Shock 40

EB Medicine

NOVEMBER 1, 2018

Jeff: Next, make sure that all patients with high voltage injuries have an EKG and continuous cardiac monitoring. Those with low voltage injuries and a normal EKG do not require monitoring. Jeff: Real quick – in case you missed it – ultrasound sneaks in again. Let’s move on to treatment.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

Mind The Bleep

NOVEMBER 21, 2023

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!

Documentation/Coding 52

Documentation/Coding COPD EKG/ECG Wellness 52

Taming the SRU

MAY 1, 2023

Exertional Hyperthermia Patients with heat stroke will present with Temp > 104, AMS, or seizures.

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

It was peer-reviewed by Joseph Habboushe, assistant professor at NYU and Nadia Maria Shaukat, director of the emergency and critical care ultrasound at Coney Island Hospital in Brooklyn, New York. First up is the link between cannabis use and stroke or TIA. times higher risk of stroke or TIA. times higher risk of stroke or TIA.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Dr. Smith's ECG Blog

APRIL 8, 2015

Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Abnormal ECG – looks for cardiac syncope. Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

EMDocs

NOVEMBER 4, 2024

Pain can be associated with a friction rub on cardiac auscultation, a pericardial effusion on a bedside echocardiogram, or diffuse ST elevations on an EKG. Evaluation by ultrasound of traumatic rib fractures missed by radiography. Up to two-thirds of rib fractures are missed on initial chest radiographs. 2020;120(10):696-697.

Emergency Department 99

Emergency Department Fractures Burns EMS 99

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.

Documentation/Coding 52

Documentation/Coding Dislocations Ultrasounds Wellness 52