Archive for January2010

73 yom CC: Chest Pain

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Here’s a case that was submitted by a reader from the UK. He’s a new EMT in his first 6 months who has chosen to remain anonymous. In his own words: Presenting Complaint: Chest Pain History of Presenting Complaint: 73 year old male with cardiac history complained of retrosternal chest pain whilst getting out bed […]

Need an AED? There's an app for that!

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 Photo credit: First Aid Corps Photo credit: First Aid Corps I ran across an interesting story from medgadget.com entitled iPhone AED Locator May Help Save Lives in a Hurry. It talks about how the UK’s First Aid Corps is saving lives with iPhones! First Aid Corps, an organization working on helping the public respond to […]

Discordant ST-Segment Elevation in LBBB or Paced Rhythm

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If you’ve been following the Prehospital 12-Lead ECG blog for a while, you know that I’m advocate of using Sgarbossa’s criteria to help identify acute STEMI in the presence of left bundle branch block (LBBB) or paced rhythm. According the Sgarbossa’s original criteria, 5 mm of discordant ST-segment elevation is required to identify AMI in […]

The Six-Step Method for 12-Lead ECG Interpretation

I’m sometimes asked how I approach 12-lead ECG interpretation. I use what I call the “Six-Step Method” (which actually has seven steps). It goes like this: 1.) Rate and rhythm 2.) Axis determination 3.) QRS duration (Intervals) 4.) Morphology 5.) STEMI mimics 6.) Ischemia, Injury, Infarct “Step 7” is a rule I started throwing in […]

EMS crews from Johnson County, KS to use therapeutic hypothermia

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EMS crews from Johnson County, KS (JoCo EMS a.k.a. Med-Act) will now be using therapeutic hypothermia for select cardiac arrest patients. “By using bags of child salt water, emergency responders in Johnson County can significantly increase survival rates for some cardiac arrest patients. For patients who have been resuscitated but still aren’t waking up, paramedics […]

Gordon Ewy MD: "We're about at the tipping point."

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Dr. Gordon Ewy from the University of Arizona is probably the World’s leading advocate for “cardiocerebral resuscitation” (as opposed to cardiopulmonary resuscitation). In other words, continuous chest compressions. The American Heart Association stopped short of advocating continuous chest compressions for professional rescuers in 2005, but Dr. Ewy thinks we may finally be at the “tipping […]

Maya Glyphs and 12-Lead ECGs

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I watched an outstanding documentary last night on Neflix called Breaking the Maya Code. It was based on a book of the same name by Michael D. Coe. The documentary examined how passionate researchers broke the code of the Maya glyphs over the course of decades. You can see the trailer here. [youtube=http://www.youtube.com/watch?v=Sq3SSWjCLQc] I found […]

Prehospital ECG Speeds STEMI Care

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MedPage Today is reporting something that should come as no surprise to anyone who’s been paying attention. Photo credit: MedPage Today It’s a review of Rao A, et al “Impact of the prehospital ECG on door-to-balloon time in ST-elevation myocardial infarction” Catheter Cardiovasc Interv 2010; 75: 174-78. They write: “Transmitting ECG results from the field […]

Regional STEMI Transfer Systems: The Mayo & NC RACE Experiences

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Here’s an interesting tweet from ACCinTouch on Twitter. D2B webinar Regional STEMI Transfer Systems: The Mayo & NC RACE Experiences Event Date: January 28, 2010 at 02:00 PM Eastern Standard Time Register now!

Rhythm Challenge #2

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Here’s an interesting rhythm strip that was captured in the days before my EMS system had 12-lead ECG monitors. What do you think? *** Update 01/20/2010 *** Here is the rhythm strip taken on arrival at the hospital. Here is the 12-lead ECG that was captured at the hospital. Does that change anything?

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