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 […]
Here’s a great story from WSFB-TV Channel 3 Eyewitness News (Hartford-New Haven) featuring our very own Peter Canning from the Street Watch: Notes of a Paramedic blog! Watch as Peter calls in a “definite STEMI Alert” and activates the cath lab! Click HERE for the best quality video without commercials. Screen shots below.
Some of you are probably wondering whether or not I’d ever condone giving a calcium channel blocker to a wide complex tachycardia in the field. A recent case submitted by Robert Bees demonstrates a situation where I might consider it (or at least not criticize someone for considering it). EMS is called to a 90 […]
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 […]
EMS is dispatched to a 72 year old male patient. Third party call. History of Parkinson's Disease. Patient is conscious. No further information. On arrival, EMS finds a 72 year old Spanish-speaking male. Through an interpreter the lead paramedic determines that the patient became dizzy, fell down, and hit his head. A small hematoma is […]
A faithful reader (and movie star) brought an interesting PSA to my attention. It’s a Heart Health Awareness video from Denver Health. The video is interesting because it shows a heart attack and associated cardiac arrest from a patient’s perspective, including all phases of care. First, the patient is struggling as he walks down the […]
In my previous post “Inappropriate or inappropriate ICD shocks – Part III” I talked about my experience contacting the “Big 3” implantable medical device companies (Boston Scientific, Medtronic, and St. Jude Medical). Here’s what I wrote: This was nothing like dealing with the banking, cell phone, or computer industries! There were few tele-prompt menus keeping […]
If you’ve been following the Prehospital 12-Lead ECG blog for a while, you know that I’m advocate of using Sgarbossa’s criteria to help identify acute STEMI in the presence of left bundle branch block (LBBB) or paced rhythm. According the Sgarbossa’s original criteria, 5 mm of discordant ST-segment elevation is required to identify AMI in […]
Here’s an interesting rhythm strip that was captured in the days before my EMS system had 12-lead ECG monitors. What do you think? *** Update 01/20/2010 *** Here is the rhythm strip taken on arrival at the hospital. Here is the 12-lead ECG that was captured at the hospital. Does that change anything?
Keith Lurie, M.D. Co-Director, Cardiac Arrhythmia Center, Central Minnesota Heart Center, St. Cloud, MN Staff Cardiologist, St. Cloud Hospital Professor of Internal and Emergency Medicine, University of Minnesota Chief Medical Officer, Advanced Circulatory Systems Dr. Lurie – thank you for this opportunity to discuss impedance threshold device technology and the ROC PRIMED study. I see […]