DNRs, Falsifying Official Documents, and Compelling Reasons

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Image credit: Billie Ward – Creative Commons I originally posted this on my personal Facebook page but there appears to be a lot of interest so I decided to post it here also. The Staten Island Advance newspaper reported on May 22, 2015: Two FDNY paramedics are accused of lying about administering aid to a dying […]

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.

Proficiency vs Deficiency… The Art Of Electrocardiography Analysis

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Understanding the different types of  assessments, assessment tools, and findings acquired from these assessments, are all part of proper patient care in both acute and chronic emergency medicine management, in every realm of the term “PATIENT CARE”. One of the most important tools, in both the prehospital setting and long term care, is the 12 […]

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, […]

Revolutionizing Pediatric Resuscitation, JEMS Games Finals, and a Very Serious Topic #EMSToday2015

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Friday, February 27 Okay, I admit it. I’m 43 years old and I can’t party like I used to. I needed a little help yesterday morning after ZOLL SHOCKFEST. But, I had an important meeting to attend with three amazing women who keep the trains running on time at EMS Today 2015 – MaryBeth DeWitt (@dewittmarybeth), […]

Meetings, Great Classes, and Celebration! #EMSToday2015

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Thursday, February 26 My day started early (these blog posts don’t write themselves you know!) and then I was off to my first ever JEMS Editorial Board meeting. As the “new guy” I had resolved not to cause too much trouble. A.J. Heightman (@AJHeightman) was suffering a bit of laryngitis which gave everyone good-natured laugh at A.J.’s […]

From Precons to EMS 10 Awards and Nightwatch! #EMSToday2015

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Wednesday, February 25, 2015 What an awesome day at EMS Today 2015! Kelly and I headed over to the Convention Center to get registered and ran into our very good friends Nick Nudell (@RunMedic), Chris Montera (@geekymedic), and Anne Robinson Montera (@CaringAnne). Nick and I started the EKG Club many years ago as an email-based discussion […]

A visit to Johns Hopkins #EMSToday2015

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Tuesday, February 24, 2015 We arrived a day early into Baltimore and decided it would be a good idea to visit what is arguably the nation’s best hospital. Johns Hopkins Hospital’s core values include Excellence & Discovery, Leadership & Integrity, Diversity & Inclusion, and Respect & Collegiality and you sense when you’re walking around that […]

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

JEMS Talk: Google Hangout

Comments
Jake
What If We’re Wrong? Prehospital ECG Interpretation
One thing that seems to stand out is that EMS systems with good 12-lead training seemed to perform on a level approaching or equivalent to ED physicians. My impression, from what I see in these blogs and discussion groups, as well as my own personal experience, is that 12-lead acquisition and interpretation is being poorly…
2015-06-01 14:53:04
Ray
Proficiency vs Deficiency… The Art Of Electrocardiography Analysis
If you'll forgive comments on the strip with the artifact: 1. Lead three is most helpful. Take calipers and look at the beats that go downward (below the baseline). These are suspicious for being the underlying rhythm. If you then use this caliper width across the strip, it allows you to identify all of the…
2015-05-31 17:42:59
Ray
Proficiency vs Deficiency… The Art Of Electrocardiography Analysis
My read on the top strip is: 1. Normal sinus rhythm (notice that the atrial rate is around 90 bpm and is not disturbed). The term "normal" and "sinus" actually applies to the atrial rate, not the ventricular response. (reference Marriott's Practical Electrocardiography) 2. The ventricular response is principally 3rd degree AVB. The PR interval…
2015-05-31 17:29:44
Mike
Proficiency vs Deficiency… The Art Of Electrocardiography Analysis
Common sense is 99% of what we do. Use it and you will have a long and gratifying career.
2015-05-29 21:28:31
Matt King
Snapshot Case: What Happened?
Also I would be moving the combo pads around after the first unsuccessful shock to try and find the ectopic foci.
2015-05-29 10:57:55

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