Tag Archives: Prehospital 12-Lead ECG blog

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 […]

Update to: 78 yom CC: "Chest heaviness"

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Lots of interesting comments on this case. Here is the update. I opted to treat this patient as a presumed monomorphic ventricular tachycardia which is hemodynamically stable. I placed an 18 ga catheter in his left AC at a TKO rate. At approximately 1005 I administered 130mg (1.5mg/kg) of Lidocaine slow IV push which had […]

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. […]

78 yom CC: "Chest heaviness"

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Here’s an interesting case submitted by Alex Kroeze. He is currently taking a sabbatical from blogging but was kind enough to share this interesting case with me. Here is the story in Alex’s own words. 78 year old male with a history of MI with cardiac arrest around 1975 as well as diabetes (metformin) and […]

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 […]

Heart attack study looking at whether giving clot-buster in ambulance is best

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Photo credit: The Canadian Press A recent story from the Canadian Press talks about the international STREAM study (Strategic Reperfusion Early After Myocardial Infarction). “It’s widely recognized that the faster you treat a heart attack, the better the outcomes,” says Dr. Warren Cantor, a cardiologist at Southlake. “You can preserve heart muscle and increase a […]

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