Transcutaneous cardiac pacing is an effective procedure for patients experiencing unstable bradycardia. Or is it? If you’ve read Tom’s introduction to the subject of false capture you’re already ahead of the game. We’ve shown case after case of unstable bradycardia patients receiving ineffective transcutaneous pacing due to a lack of capture. In each case, phantom pacing impulses […]

This is the conclusion to 47 year old male: Holiday Indigestion. Thanks go to a long time reader Nicholas Eisele for this holiday case! Editor's Note: sorry for the delay, it helps to press "publish"! When we left off, our patient was in the back of the truck with a burning sensation radiating to his […]

Thanks go to a long time reader Nicholas Eisele for this holiday case! As always, details have been changed to protect patient privacy. It is a blustery Christmas morning when you and your partner are dispatched for a 47 year old male with chest pain. Firefighters are already on scene obtaining a history and vitals […]

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 is the discussion for Comparing 12-Leads: Common Error or Common Disease? All of our readers were on the right track, and many were spot on! Sometimes, troubleshooting an ECG is more than just lead placement. In this case report, we had three 12-Lead ECG's, all featuring a similar pattern: inappropriate R-wave progression. Initially, when […]

This is the discussion for 50 year old male CC: Chest Pressure. We could not have been happier at the number of insightful comments we received on this case! Many of you caught on to our purpose for this case as we could not have picked a better borderline example! When we last left our […]

We hope you enjoy this case, as always some details have been changed to protect patient privacy. It's around 05:00 when the tones go off at your fire station for a medical response at a large apartment complex. You leave the bunkhouse with the engine crew and check enroute. Dispatch relays you are headed to […]

This is the discussion to 64 year old male CC: Indigestion. If you recall, we had a stubborn gentleman complaining of indigestion with a significant cardiac history. Considering the symptoms kept our patient awake, are highly suggestive of a coronary event, and we have uncompensated hypotension, we should have a keen interest on any ECG […]

One of our faithful readers, Nicholas Eisele, sent in this interesting case study. As always, changes have been made to protect patient confidentiality. After a long night of car wrecks, you get dispatched right before shift change on a Sick Person call. As you arrive, your partner states she may have been here once or […]

This is the conclusion to 54 year old female CC: BLS intercept. I did not expect to get so many comments! Great discussion on many points. It even afforded an opportunity to review atrioventricular blocks. Going back to the case let’s look at the initial 12-Lead ECG. As many readers noted, there is a lot […]