Tag Archives: EKG

65 year old male CC: Cardiac arrest on the tennis court

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65 year old male collapses while playing tennis. The scene is less than 1 minute from the fire station. On arrival, bystanders are providing rescue breaths but no chest compressions. Medical history is unknown. Initial rhythm: First shock: Return of spontaneous circulation (ROSC) noted. Rhythm strip: 12 lead ECG: The patient is still unconscious. LMA […]

81 year old female CC: ICD shocks x6

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EMS responds to a 81 year old female who was implanted with “a pacemaker” 2 weeks ago. She complains that the device has shocked her 6 times. On arrival the patient is found sitting in a chair. She is anxious but alert and oriented to person, place, time and event. Vital signs: Resp: 18 Pulse: […]

Found on the Lifenet Receiving Station

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Is there anything about this ECG (other than the poor data quality) that interests you? The patient was a 90 year old male, fall with injury. Also complaining of pain between the shoulder blades. *** UPDATE *** This ECG caught my eye because it satisfies one of Sgarbossa’s criteria for the identification of AMI in […]

65 year old female CC: Chest pain

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EMS is called to a hotel for a 65 year old female complaining of chest pain. On arrival, the patient is found sitting on the edge of the bed in her hotel room. She is alert and oriented to person, place, and time. Her skin is pink, warm, and dry. Onset: 30 minutes ago while […]

Left anterior fascicular block (LAFB)

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A reader by the name of Jesse contacted me and wrote: I have a question. I’m trying to learn more about fasicular and hemi blocks. I was curious if you have posted, or intend to post, any information regarding these. I understand this is all done on your free time, so no rush at all. […]

Narrow complex tachycardias – Part III

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Documenting the heart’s response to adenosine Let’s look at some different cases where adenosine was used. Rather than give you all the details about the age, gender, chief complaint, and vital signs, I’m just going to show you the rhythm strips. Right now I’m only concerned with how the heart behaves during the administration adenosine. […]

43 year old female CC: "Indigestion-like" chest discomfort

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Thanks to Jim Tarro for the following case study 43 year old female presents to EMS with “indigestion-like” chest discomfort. She states that it “feels like a previous heart attack.” Onset: Several hours ago Provoke: Antacids make the pain feel better Quality: “Indigestion-like” chest pain Radiate: The pain does not radiate Severity: She gives the […]

What's the heart rhythm?

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You are called to the residence of 85 year old male complaining of chest discomfort. Note: The details of the history and clinical presentation have been lost. The cardiac monitor is attached. What's your interpretation of this ECG? *** UPDATE *** Some very interesting comments so far…. Let's see if a review of the 12 […]

Narrow complex tachycardias – Part I

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I've come to dislike the term "SVT" (supraventricular tachycardia). In the first place, it's not an arrhythmia. It's an umbrella term that covers a group of arrhythmias which require the AV node for their maintenance. Most importantly, it includes sinus tachycardia! For some reason, this is a difficult concept for many clinicians to grasp, partly […]

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