Archive for April2009
Prehospital ECGs and STEMI Receiving Centers
An important paper has been published that deserves to be read in its entirety. Rokos IC, French WF, Koenig WJ, et al. Integration of pre-hospital electrocardiograms and ST-elevation myocardial infarction receiving center (SRC) networks: Impact on door-to-balloon times across 10 independent regions. J Am Coll Cardiol Cardiovasc Intervent 2009; 2:339-346 Here are some highlights: “There […]
Things that make you go hmmm
It seems incredible that we can email a photograph around the world, but we haven't yet found an easy way of transmitting an ECG to a nearby hospital. – Ivan Rokos, MD to heartwire [1] Question: What's the incentive for industry to invent a simple, cost effective method for transmitting the prehospital 12 lead ECG […]
Top 10 myths about prehospital 12 lead ECGs
A recent thread at JEMS Connect has reminded me how many myths are circulating about prehospital 12 lead ECGs. 1.) If you’re close to the hospital, performing a prehospital 12-lead ECG is a waste of precious time. The prehospital 12-lead ECG is an important triage tool. The closest hospital is not necessarily the closest appropriate […]
Recurrent syncope and bifascicular block
You are dispatched to an “unknown medical complaint.” En route to the scene, dispatch advises you that a 66 year old male is complaining of a fall with injury, chest pain, left arm pain, and nausea. On arrival, the patient is standing in his kitchen. He is pale and extremely diaphoretic. You direct him to […]
EMS 12-Lead
Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
- Axis (1)
- Hyperkalemia (1)
- MI (2)
- Paced Rhythm (1)
- Right Ventricular Involvement (1)
- Sgarbossa's Criteria (2)
- COPD (1)
- 12 Rhythms of Christmas (8)
- 12-Leads of Christmas (12)
- 360 Degree Heart (5)
- Dogmalysis (1)
- ECG Mixtape (2)
- Snapshot (3)
- Spot the STEMI (1)
- Adenosine (1)
- Pharmacodynamics (1)
- Pharmacology (3)
- Pulsus Paradoxus (1)
80 Year Old Female: “Rapid Heart Rate”
On first glance it looks like afib rvr new onset. Without marching the qrs complexes out though, it looks like they are pretty regular, like an accelerated junctional rhythm with every 4th beat dropped. Looks like a p wave can be seen in v1/2, but not sure and I would print a longer strip out…
2019-01-22 13:42:57
58 Year Old Male, Workout Worry
@ Eli — I don’t see AFlutter. That is, I see no indication of regular atrial activity at a rate consistent with AFlutter. Instead, the rhythm is irregularly irregular without P waves = AFib at a controlled ventricular response. In my opinion, one doesn’t need Sgarbossa criteria here to activate the cath lab. So, yes the…
2018-09-13 02:09:24
Is epinephrine harmful in cardiogenic shock?
Sorry about that; I copied the quote from the article and my browser automatically changed the "μ" to an "m". Thanks for noticing, and thanks for pointing it out in the most passive-aggressive manner possible.
2018-09-12 16:45:26
Is epinephrine harmful in cardiogenic shock?
Quote: "... espite the use of >1 mg/kg/min of epinephrine/norepinephrine ..." You guys know the difference between mg and µg, do you?
2018-09-12 08:08:40
Electrocardiographically Silent High Lateral STEMI Equivalent
Hi Tom. This is a great case — so NICE that you posted it for others to learned from. But as I commented several times when you sent this case around to our group — the T waves in V2,V3 are disproportionately peaked and transition occurs early (between V1-to-V2) — so the chest leads are NOT…
2018-08-14 08:38:03
