71 Year Old Male: Chest Discomfort- Discussion

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Here is the discussion for “71 year old male: chest discomfort” let’s review the prehospital 12 lead:     Here are the precordial leads blown up:   There is slight ST elevation in V1,  ST elevation in V2 (saddleback morphology), as well as slight ST elevation in V3 and V4. The STE in V3 and V4 […]

71 year old male: Chest Discomfort

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  This very interesting case comes from Bryan F, a Paramedic from Long Island. A 71 year old male is cooking breakfast when he experiences sudden onset of 10/10 chest discomfort. He waits 20 minutes or so for it to subside, but it does not and he calls 911. EMS arrives to find him lying […]

In Defense of Morphine (Part 2)

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Yesterday, I introduced some of the history preceding the recent Thrombosis and Haemostasis study looking at morphine in patients experiencing ST-elevation myocardial infarctions (STEMIs). [For the curious, we’ll talk about that new article in Part 3. I have to work today, so I can’t guarantee that it’ll be up tomorrow, but soon!] We started with […]

In Defense of Morphine (Part 1)

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Every time I hope this debate is going to die out, or that science will swing back toward rationality, another study gets published and throws a wrench in things. I’ll type this very carefully: There is no convincing evidence that morphine causes harm to patients experiencing ST-elevation myocardial infarctions (STEMIs). As long as there isn’t […]

50 Year Old Male: Chest Pain, Hypotension, Pulmonary Edema (Conclusion)

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This is the conclusion to Friday’s post. If you haven’t seen it, I suggest checking out the original patient presentation and ECG first. We have reproduced this case courtesy of Dr. Musa A. Sharkawi (@MusaSharkawi on Twitter). A 50-year-old man presented with sudden-onset chest pain, respiratory distress, pulmonary edema, and hypotension. This was his ECG: […]

50 Year Old Male: Chest Pain, Hypotension, Pulmonary Edema

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Physician and cardiovascular fellow Dr. Musa A. Sharkawi shared this ECG on Twitter (@MusaSharkawi) and has graciously allowed us to reproduce it here. A 50-year-old male presents with a chief complaint of abrupt-onset severe chest pain. He is pale, diaphoretic, and ill-appearing—in moderate respiratory distress with extensive biateral crackles and a low blood pressure. Further […]

What are the Essential Elements of High Performance CPR?

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Adult High Performance CPR (HP-CPR) Demo at the South Carolina Resuscitation Academy! Hilton Head Island Fire Rescue: Tim Santini, Jon Ceiply, Shane Marstiller, Sean Kavlick What is High Performance CPR? High Performance CPR typically consists of expertly performed BLS with strict attention to: Minimally interrupted chest compressions Ensuring optimal rate (100-120) Ensuring adequate depth (2 […]

Rapid Prehospital Evolution of STEMI

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82 year old male, in good physical shape, stops at a cafe for lunch after cycling for an hour. Witnesses report a syncopal episode lasting approximately 30 seconds. Patient history significant for prior MI requiring 3 stents. No other significant history. Patient denies any CP, SOB, N/V, lightheadedness. In fact, he denies any complaints at […]

Triaging Triage ECGs

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I’ve spent nine years working in an emergency department, which means I’ve also spent nine years performing electrocardiograms at triage. With a couple thousand waiting-room ECGs under my belt, I’ve noticed a few things: A lot of ECGs are ordered at triage. Many of them are performed on low-risk patients. Very few of those ECGs […]

ECG Mixtape: Vol. 2

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Welcome to the second installment in our ECG Mixtape series! It looks like this will be an irregular publication while we streamline our process of picking cases and getting permission to reproduce them. Enjoy! Pick of the Week This weeks top pick comes from cardiologist Dr. Gianni Manzo in São Paulo, Brazil, who shared this […]

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