Tag Archives: EKG

79 year old male CC: Shortness of breath

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Here’s another interesting case submitted by Geoff Dayne. 79 y/o male c/o non-provoked SOB without CP. Patient was found sitting upright, tripodding, 1 word dyspnea. Lung sounds: extremely decreased tidal volume. EMS crew was unable to tell if there was rales or wheezing. Past medical history: HTN, dyslipidemia, CHF, pacemaker (recently implanted within a week […]

The missed STEMI

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Here is the history of present illness recorded by the physician at the time of the patient’s arrival in the emergency department. “This 67-year-old male presents via EMS for evaluation of weakness, dehydration and one episode of nausea/vomiting. The symptoms began after approximately one hour of jogging this morning. The patient did not eat breakfast […]

Rhythm Challenge #4 – Discussion

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I’d like to thank everyone for the great comments on the most recent “rhythm challenge”. This turned out to be a more interesting rhythm strip that I thought! I’m going to break this down using some standardized steps that I follow for difficult rhythm strips. When I look at a strip, the first thing I ask […]

74 year old male CC: Chest pain

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74 year old male presents to EMS with a chief complaint of chest pain. Onset approximately 1 hour prior to the 9-1-1 call. No further details of the OPQRST are currently available. I will update the case with this information as soon as it is available, along with the physical exam. Vital signs: Resp: 20 […]

46 year old male CC: Chest Pain

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Here’s an interesting case from Associate Editor Christopher Watford. As a reminder, Christopher has his own blog called My Variables Only Have 6 Letters. 46 year old male presents to EMS complaining of chest pain. After sitting down on the gurney he states, “My heart is jumping out of my chest!” Onset: Sudden while doing […]

23 year old male CC: Chest Pain

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Here’s a fascinating case submitted by Geoff Dayne. EMS is called to a VA clinic for a 23 year old male who came in to get checked into the system. Somewhere in the exchange, he mentioned that he had been experiencing chest pain off & on for just over a month. Onset: Today’s pain came […]

12 year old male CC: Palpitations

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Here’s a case submitted by Bob Sullivan, NREMT-P from New Castle County EMS in Wilmington, DE. The case occurred six years ago so certain details are missing. However, there is more than enough here to discuss the most relevant points about the case. The patient was a 12 year old male whose only complaint was […]

57 yom CC: Cardiac arrest

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Here’s another interesting case submitted by a reader who wishes to remain anonymous. While we’re on the subject, I’d like to thank my readers for the interesting case studies that have been coming in! This is what the Web 2.0 experience is all about! We’re learning a lot from each other and that’s the difference […]

68 year old male CC: Chest Pain

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Here’s another great case submitted by Robert Bees. EMS is called in the very early morning to a 68 year old male complaining of chest pain and shortness of breath. On arrival, the patient is anxious and appears acutely ill. He is oriented to person, place, and time. Skin is cool, pale, and diaphoretic. The […]

72 year old male CC: "Unknown problem" – Conclusion

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Here is the conclusion to 72 year old male CC: Unknown problem (man down) Here was the initial 12-lead ECG.   Based on this ECG the lead paramedic called a "STEMI Alert" and transmitted the ECG to the receiving hospital. The on-duty ED physician received the ECG and the paramedic's radio report. The ED physician […]

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