Anterior T wave inversions and PE.

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Last week, I described the case of a middle-aged male with a vague history of heart failure who had been having progressive shortness of breath for 4-5 days. On the day he called 911, he had been walking a short distance when he syncoped. EMS obtained an ECG: Compared with the prior ECG, the anterior […]

100 yof CC: Rib pain and intermittent spasms

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Here’s an interesting set of ECGs sent to us by Frank Intessimoni of Atlanticare EMS. You can follow Frank on Twitter: @njmedic3228. EMS is called to a local nursing home for a 100 year old female patient who had been complaining of rib pain and intermittent spasms for 3 days. Vital signs were assessed. RR: […]

Not just S1Q3T3: Look at the other 10 leads!

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It was a slow morning in the ED, so I was able to catch the medic as she came in with the patient. “Hey Leigh, what do you have for us? Got an interesting ECG?” “Well, maybe,” she replied as she wheeled by with a comfortable looking middle-aged male, “here, take a look at it […]

What it Looks Like: Cardiac Arrest

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This article is a quasi-cross-post from the website of our good friend Brandon Oto over at EMS Basics. He’s been gracious enough to allow us to adapt the original post from his What it Looks Like series over here. We highly suggest that you go check out the amazing and highly practical writing he does […]

Conclusion to 83 Year Old Male: Shortness of Breath

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Last week we presented the ECG of a patient experiencing progressively worsening shortness-of-breath over the course of a day and some marked ECG abnormalities. If you haven’t done so already, it would probably be a good idea to check out the original post first. Strap in, this is going to be a thorough discussion. Here […]

83 Year Old Male: Shortness of Breath

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You are called to the residence of an 83 year old male with a chief complaint of shortness of breath. On arrival you find a sick-appearing gentleman working hard to breath. He states that he woke up feeling a bit weak this morning with dyspnea-on-exertion that it has gotten progressively worse over past 12 hours—to […]

Understanding Amiodarone

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Recently, I was part of a short discussion between fellow healthcare providers of different levels of care, about Amiodarone and its expected effects on the heart during Ventricular Tachycardia (VT). I figured, I could break it down and write a short summary of how it works.  Most healthcare providers are familiar, or at least have […]

Calcium and Hyperkalemia

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“Calcium Chloride/Gluconate are used during Hyperkalemia induced ECG changes to reduce Serum Potassium.” The answer is:    False! The majority of Potassium in our body is found intracellular. Only a very small percentage (about 2%) is found extracellular, ranging between 3.5- 5.5 mEq/L. As extracellular Potassium levels increase, the action potential threshold decreases, for example, instead of […]

The 360 Degree Heart – Part II

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The first post in our “360 Degree Heart” series attempted to visualize how the different frontal plane (limb) leads relate to one another. We also introduced the concept of “negative leads,” which are just the standard leads flipped upside down. If you didn’t read that post it would probably be helpful to start there. This […]

68 y.o. male w/ weakness: conclusion – “Treat the monitor.”

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But perhaps not the computer… Recap of the case: A patient with CHF, COPD, and diabetes called after falling, apparently due to weakness. Their ECG was recorded by the paramedic: Interpretation: The underlying rhythm is unclear, due to artifact, but there are very wide QRS complexes. The computer measures the QRS as 158 ms, which […]

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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Comments
Nick
100 yof CC: Rib pain and intermittent spasms
Can't be a potassium imbalance. The TW's wouldn't change and then change back. If it was coronary spasm, I would expect some ST segment elevation. The TW'S are also not hyperacute (peaked). Does she wear some sort of electronic stimulator?
2014-11-19 01:05:43
Anterior T wave inversions and PE. | EMS 12 Lead
Not just S1Q3T3: Look at the other 10 leads!
[…] Last week, I described the case of a middle-aged male with a vague history of heart failure who had been having progressive shortness of breath for 4-5 days. On the day he called 911, he had been walking a short distance when he syncoped. EMS obtained an ECG: […]
2014-11-18 18:33:47
Christine
100 yof CC: Rib pain and intermittent spasms
I believe this may be coronary artery vasospasm.
2014-11-18 11:02:45
Ian Fudge
What it Looks Like: Cardiac Arrest
this is really interesting because something similar happened to a patient as I sat them up in bed after delivering them to a community hospital in fact I even turned to his son and said "does dad suffer with epilepsy?" And then turned back and realised he wasn't breathing
2014-11-18 07:59:13
Dustin
100 yof CC: Rib pain and intermittent spasms
External interference? Something like a bladder stimulator or spinal stimulator.
2014-11-18 00:32:54

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