Archive for September2009

Congratulations to Dr. Michel LeMay

Entry Img

Congratulations are in order for Dr. Michel LeMay of the Universtiy of Ottawa Heart Institute. He was recently one of eight Canadians recognized with an award from the Canadian Institute of Health Research (CIHR) and the Canadian Medical Association Journal (CMAJ) for “developing a new way to handle heart attacks that empowers paramedics to read […]

Chicago ambulances lack EKG machines

Entry Img

Here’s an interesting story from ABC 7 (WLS-TV) in Chicago. “Some heart attack patients in Chicago may face an emergency situation when they are transported to the hospital in one of the city’s ambulances. The reason for that: those vehicles do not carry crucial equipment that can provide the patients with life-saving treatment.” See the […]

Stump the Experts – EP Lab Digest

Entry Img

My “Stump the Experts” column is up at EP Lab Digest. The Case of the Tachy Trucker can be found HERE. If you think you know the answers to the questions in Part I and Part II, please email your guesses to the Managing Editor Jodie Elrod. Good luck!

STEMI Alert protocol

Entry Img

I’ve been working on a STEMI Alert protocol for my fire department. Basically, this is how we will notify our receiving hospital of a possible STEMI. At present, a STEMI Alert will not have the force of a Code STEMI which is the term the ED physicians use to activate the cath lab. The STEMI […]

Chest pain and transient (subtle) inferior ST-segment elevation

Entry Img

A 45 year old male reports to the fire station complaining of chest pain. Onset: 15 minutes ago Provoke: Nothing makes the pain better or worse Quality: A “heavy pressure” in the center of the chest Radiation: The pain does not radiate Severity: 6/10 Time: The patient has been experiencing chest pain on and off […]

Chest discomfort and very subtle acute inferior STEMI

Entry Img

A 59 year old male presents to the fire station during a 12-lead ECG class (you can’t make this stuff up) and complains of chest discomfort. He is anxious, appears acutely ill, and is rubbing his chest. He senses that “something is wrong.” Onset: 30 minutes ago while patient was walking on the beach Provoke: […]

New technology, cooperation increases heart attack victims' chances of survival

Entry Img

Photo credit: Jay Karr, The Island Packet Improved technology and advanced cooperation between Hilton Head Hospital and two local EMS systems over the past two years has led to a drop in the amount of time it takes to get patients suffering the deadliest kind of heart attack into surgery, local hospital and EMS officials […]

What ever happend to good old bretylium?

Entry Img

[youtube=http://www.youtube.com/watch?v=gEl-59jHqHA] I love how the doctor claps his hands after he orders bretylium. Yes, this is the anwswer! This is the drug that will successfully resuscitate the extraterrestrial! At 0:30 I’m certain he is bagging E.T. at a rate of at least 100. I know this isn’t the normal serious tone of the Prehospital 12 […]

44 year old male CC: Palpitations

Entry Img

Here is an absolutely fascinating case submitted by G.W. Lyster (who credits the case to J.C. Neetz). It's a patient who presented with a wide complex tachycardia who ended up receiving the kitchen sink! Here are the basics. 44 YOM C/O "palpitations". Denies CP, SOB, N/V, dizziness, weakness. Pt in NAD. Meds include Coreg, et […]

Found on the Lifenet Receiving Station

Entry Img

Here’s an interesting set of ECGs I found on the Lifenet Receiving Station. They were transmitted to the emergency department by a neighboring EMS system. I have no details of the history or clinical presentation. ECG #1 ECG #2 What do you think?