EMS is called to a hotel for a 65 year old female complaining of chest pain. On arrival, the patient is found sitting on the edge of the bed in her hotel room. She is alert and oriented to person, place, and time. Her skin is pink, warm, and dry. Onset: 30 minutes ago while […]

Lots of interesting comments on this case. Here is the update. I opted to treat this patient as a presumed monomorphic ventricular tachycardia which is hemodynamically stable. I placed an 18 ga catheter in his left AC at a TKO rate. At approximately 1005 I administered 130mg (1.5mg/kg) of Lidocaine slow IV push which had […]

A reader by the name of Jesse contacted me and wrote: I have a question. I’m trying to learn more about fasicular and hemi blocks. I was curious if you have posted, or intend to post, any information regarding these. I understand this is all done on your free time, so no rush at all. […]

Here’s an interesting case submitted by Alex Kroeze. He is currently taking a sabbatical from blogging but was kind enough to share this interesting case with me. Here is the story in Alex’s own words. 78 year old male with a history of MI with cardiac arrest around 1975 as well as diabetes (metformin) and […]

This is the conclusion to Syncope, Chest Pain, and LAD Occlusion – Part 1. Let’s take another look at the 12-lead ECG. There is a regular rhythm at a rate of 60 (using the large block method there are 5 blocks between R-waves). The QRS complex is narrow at 86 ms. There are P-waves in […]

Documenting the heart’s response to adenosine Let’s look at some different cases where adenosine was used. Rather than give you all the details about the age, gender, chief complaint, and vital signs, I’m just going to show you the rhythm strips. Right now I’m only concerned with how the heart behaves during the administration adenosine. […]

Thanks to Jim Tarro for the following case study 43 year old female presents to EMS with “indigestion-like” chest discomfort. She states that it “feels like a previous heart attack.” Onset: Several hours ago Provoke: Antacids make the pain feel better Quality: “Indigestion-like” chest pain Radiate: The pain does not radiate Severity: She gives the […]