Tag Archives: Vince DiGiulio

The 12 Rhythms of Christmas: Sinus Tachycardia

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This article is the first in our latest series, The 12 Rhythms of Christmas, where each day we examine a new rhythm disorder. It’s a continuation of the theme behind last year’s 12 Leads of Christmas. Sinus Tachycardia It’s one of the first arrhythmias we all learn and it seems so simple. Sinus tachycardia is […]

Spot the STEMI #1

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You have a 50/50 shot at getting this one right. Are you feeling smart… or lucky? Two 50-year-old men present complaining of chest pain x 1 hour. One patient is suffering from a very subtle acute STEMI while the other has a non-cardiac cause for his chest pain. Which patient is experiencing the subtle STEMI? […]

Conclusion to 43 Year Old Female – Chest Discomfort After Eating

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This is the conclusion to our case from last Saturday. I suggest reviewing the original case presentation before diving into the discussion here. A 43-year-old female presents feeling like there’s a knot behind her sternum. It began suddenly just after eating lunch. This is her initial ECG: There is apparent ST-elevation in leads V1–V3. The […]

43 Year Old Female – Chest Discomfort After Eating

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You respond to an office workplace for a 43-year-old female with a chief complaint of chest discomfort. On arrival you are greeted by the patient who is pleasant and well-appearing. Her skin is warm, pink, and dry and pulse strong at the radials. Respiratory effort is normal with clear lung sounds bilaterally and she does […]

Conclusion to 59 Year Old Male: Unwell

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This is the conclusion to our latest case, 59 Year Old Male: Unwell. I suggest starting there and reviewing the scenario before diving into this discussion. I was glad to see our latest case generated quite a bit of debate. This is a difficult tracing coupled with an equally difficult clinical scenario, so it wasn’t […]

59 Year Old Male: Unwell

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**UPDATE** The conclusion to this case is now posted here. It’s the middle of the afternoon when you are dispatched to the residence of a 59 year old male with a chief complaint of general illness. When you arrive on scene you encounter a middle-aged man in obvious distress, lying on a couch. He is […]

What If We’re Wrong? Prehospital ECG Interpretation

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This article is part of a special one-day EMS blogging event called the What If We’re Wrong a-Thon. Spearheaded by Brandon Oto over at EMS Basics, the WIWWAT is an exercise in self-reflection where EMS writers examine a topic on which that they’ve historically taken a strong stance, but from the opposite point-of-view. For more […]

Snapshot Case: What Happened?

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Snapshot cases are tracings where we do not have good patient follow-up—or sometimes even clinical information—but still feel there are points worth discussing.   This is a patient who required emergent cardioversion for unstable rapid atrial fibrillation. What happened?   Tracing shared by Rob McDonald, and emergency department nurse in Queensland, Australia.

Transcutaneous Pacing Success!!! Part 2

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This is the second half of a two-part case presentation examining transcutaneous pacing. If you didn’t see yesterday’s post I highly suggest checking out Part 1 before continuing, but if you hate learning I suppose you can start here. Yesterday we examined a series of tracings that depicted transcutaneous pacing (TCP) in all its stages: […]

Transcutaneous Pacing Success!!! Part 1

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Anyone trained in transcutaneous pacing (TCP) needs to be able to identify the rhythm below instantly. It shows a patient being transcutaneously paced at 80 bpm and 125 mA on a LifePak 12 [the strip is labelled 130 mA but that refers to a point just past the end of the paper, I promise]. Well, […]

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