This is the conclusion to 53 year old male: Severe leg pain. You may wish to review the case. Before we begin, my apologies for the delay in posting this conclusion. I live in coastal NY, and we got hammered by Hurricane Sandy. It has taken me a little time to get all caught up. […]

This great case was sent in by faithful reader Bryan Brzycki, a Medic from Beaufort County. As usual, some minor information may be changed to protect patient confidentiality. It's a cloudy fall morning when the tones go off and your unit is dispatched to the residence of a 53 year old male.  When you and […]

This is part II to 59 year old male–"Lifting Boxes". You may wish to review the case. Let's review the ECG: There is sinus rhythm at about 90 bpm. Some of you saw a slight bit of ST elevation in the inferior leads, and maybe an abnormal aVL. Perhaps? Perhaps not? V1-V4 look possibly abnormal, […]

This great case was submitted by Vince DiGiulio, EMT-CC; we highly recommend you read his wonderful blog The Medial Approach to Emergency Medicine. As usual, the case has been altered to protect patient and provider privacy. You're working triage in a busy urban ED when an 88 year old female is brought in by her family. […]

This is part one of today's case study. As usual some information has been changed to protect patient confidentiality. EMS is called to the residence of a 59 year old male, who's chief complaint is chest discomfort.  As the crew enters the kitchen, they find the patient sitting in a chair surrounded by family members. […]

This is the discussion for "Snapshot: 64 Year Old Male–Chest Pain". First, let's talk about the patient presentation.What is concerning is the substernal chest pain, radiating to the shoulder and neck area. While this occurred about 30 minutes after exercise, it did not occur during exercise, so that is somewhat atypical. Still, enough red flags […]

This is the discussion for "A change of Pace: What Happened?"  My apologies for the delay! Pacemakers are amazing pieces of technology. They have evolved continually, and have given patients an increasing quality of life where none existed before. However, with this amazing technology comes a level of complexity that also has not been seen […]

Here is a challenging case this morning to stretch your mind… You are called to a 71 year old male feeling "sick". He has not felt well for the past 24 hours. He describes feelings of "general aches and pains". He has history of heart failure, for which he has an AICD. His vitals are […]

Here is the conclusion to 51 year old male: Chest Pain. You may wish to review the case. Here is the ECG again:   There is a regular sinus rhythm at a rate of about 70. The QRS is narrow. The axis is normal, at about 15 degrees. Let's take a look at the constellation […]

Here is a great case submitted by faithful reader Niels, a Paramedic in Germany. As always, some minor information may have been changed to preserve patient confidentiality. Our case today takes us overseas, to the German countryside. It's a clear blue Monday morning, 11:40 am, when you and your partner are called to a 51 […]