Good morning. It's 7:45 am on a sunny winter Monday, and you are just finishing up your holiday shopping list– it is getting down to the wire after all! The tones go off, and you are dispatched to the residence of a 63 year old female, "sick".  You arrive to a well kept two […]

This is part II to “37 year old male–CC: Chest Pain“. You may wish to review the case. So, while many of our cases are straightforward, this one is not. But hey, our patients don’t read the textbooks! First, let’s review the chief complaint: Our 37 year old male had “chest tightness”, but complained of lethargy […]

This excellent case comes to us from Paramedic Jack Buckle. Thanks Jack! You and your partner are in the middle of a busy shift, when you are dispatched to 37 year old male complaining of chest pain. It's almost 2pm, and a balmy 78 degrees. You arrive to a well kept house and find your […]

  "For heaven's sake man, treat the patient not the monitor!"  Ahh, the angry cries appear every time we post a difficult case with a challenging ECG or treatment decision.. The attitude seems intractable, despite our best efforts. Over a year ago, I wrote "Treat the Patient not the Monitor?", and not much has changed […]

  This excellent case comes to us from our friends in the UK. The author wishes to remain anonymous, but we thank him for his contribution. It is about 8am on a gorgeous Wednesday morning, when your Paramedic unit is dispatched to a 49 year old male, "chest pain". You arrive at the bungalow of […]

The original presentation of this case appeared as  "What's Wrong with Mr. Wilson?"… You can read the original post here. Much has been written lately about RBBB abnormalities that were missed.  Dr. Smith has recently posted two cases here, and here discussing this. First, let's review the 12 lead of a typical RBBB. When learning […]

  Sometimes recognizing sinus tachycardia can give us fits. What? Sinus tachycardia? One of the most basic rhythms? The discussion that follows will highlight some of the difficulties sinus tach can present at high rates. The pitfalls of using the generalized term "SVT" will also be discussed. This discussion is not meant to imply that […]

  It is a sunny January afternoon at the ER when you are called to see a 57 year old male complaining of feeling "really sick". You find your patient lying in the bed in room 3. He looks pale and short of breath. You introduce yourself and ask him why he has come in […]

Today we continue our discussion about the myths and facts of hyperkalemia with Dr. Brooks Walsh, author of the Mill Hill Ave Command blog. We also feature contributions from Dr. Stephen Smith, of Dr. Smith's ECG Blog. If you would like to refresh your memory on Part I visit here.             […]

Happy New Year everybody! We start 2013 with a continuation of our discussion about the field treatment of hyperkalemia.  It might be helpful to review the first part of the discussion," HyperK and Shades of Grey" here.  We are fortunate to have as a guest contributor Dr. Brooks Walsh of the Mill Hill Ave Command blog. […]