Here’s an awesome case submitted by Nathan Stanaway of Grady EMS in Atlanta, GA. The patient is a 53 year old female c/o chest discomfort and mild dyspnea. The pain is described as “severe” and she gives the pain a 10/10. Past medical history is significant for migraine headaches and anxiety. Patient is a poor […]
This is the discussion for the case study: 37 year old male CC: “Light-headedness” (posted earlier this week). Here’s the question asked by the paramedic who submitted the case. “The first 12 lead ECG shows Q-waves in the inferior leads. Perhaps this isn’t a surprise considering the patient’s history of MI. But what about the flipped […]
I received an excellent question this week from a reader who chooses to remain anonymous. Before we get to his question (and my answer) let’s take a look at the case that prompted the question. EMS is called to the residence of a 37 year old male c/o “light-headedness”. Upon EMS arrival the patient is […]
Here's a very interesting and unusual case submitted by a long-time reader of the Prehospital 12-Lead ECG blog named Christopher Linke (aka SoCalMedic). I'll warn you up front that the patient insisted on being transported to a hospital without specialty services so we have no information about diagnostic testing that might confirm the diagnosis. EMS […]
I have gone to the dark side and joined the FireEMSBlogs.com family! The new blog goes “live” at 12:00 p.m. EST tomorrow, August 19, 2010. The new URL is ems12lead.com. Here’s a sneak peak. Special thanks to Chris Hebert (Go Forward Media) for helping me sort through the technical issues involved. Please update your bookmarks […]
I’ve been giving a lot of thought lately to paramedic education and the problem of 12-lead ECG interpretation. Specifically, the reasons why paramedics aren’t taught to actually read a 12-lead ECG and are instead given a crash course in “STEMI recognition” which does not prepare the student to differentiate between the ST-elevation of acute STEMI […]
Here’s another case from a faithful reader who wishes to remain anonymous. No, these are not all from the same anonymous reader! EMS responds to a 58 year old male complaining of chest discomfort. Onset: 30 min ago while mopping hot tar on roof Provoke: Nothing makes the pain better or worse Quality: Dull pressure […]
As some of you may know patient safety, crew resource management, human factors, and quality improvement are areas of interest for me. This is worth your time. [youtube=http://www.youtube.com/watch?v=GOJJHHm7lnM] [youtube=http://www.youtube.com/watch?v=wpzb7nM6oFQ] [youtube=http://www.youtube.com/watch?v=6BnXs4KtER8]
This is the discussion for 54 year old male CC: Chest pain. Once again we see the importance of serial ECGs in the treatment of a suspected ACS patient. The difference between the first and second 12-lead ECG is the key to solving this case. As you can see, the T-waves become more pronounced in leads […]