It’s a sunny morning, and your EMS unit is dispatched to a residence for an 87 year old male with difficulty breathing.   You arrive on scene before the fire engine and enter the residence. Upon entering the bedroom, you find an elderly male, sitting on the edge of the bed, vomiting. He is alert and oriented x 4 (person, […]

  Here is the latest from our "Snapshot" case collection..  This ECG was taken from a 45 year old female patient who had "off and on" chest pain for about 24 hours. The discomfort radiated to her left arm, and she complained of some "dizziness".  She denies any associated SOB, or N/V.  The discomfort worsened over […]

Ok, so we understand the basics of our Cardiopulmonary System for the most part, at least most of us reading this. But, if you don’t, DON’T WORRY, we can break it down in a few simple steps… Here we  go!!! The Right Ventricle (RV) pumps blood to the lungs via the Main Pulmonary Artery Trunk which […]

  This is the discussion for our recent case 63 Year Old Female, CC: Neck and Arm Pain. Let's revisit the 12 Lead ECG: There "appears" to be a Sinus Brady rhythm at a rate of about 52 bpm, with a first degree AVB. The rhythm is regular for the first half of the ECG, then […]

  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 […]

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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 […]