Syncope and sudden death in student athletes Part 2 – EMS 12-Lead podcast Episode #2

EMS 12-Lead podcast – Episode #2 – Syncope and sudden death in student athletes Part 2

In this episode Tom Bouthillet and David Baumrind are joined by Trudie Lobban of STARS (Syncope Trust And Reflex anoxic Seizures) — a not-for-profit organization that works together with individuals, families and medical professionals to offer support and information about unexplained loss of consciousness (syncope).

Trudie Lobban
Photo credit: http://www.atrialfibrillation-us.org

To learn more about STARS see the following links:

Syncope Trust And Reflex anoxic Seizures (STARS) – International 

Syncope Trust And Reflex anoxic Seizures (STARS) – U.S.

Syncope Trust And Reflex anoxic Seizures (STARS) – International on Facebook

Syncope Trust And Reflex anoxic Seizures (STARS) – U.S. on Facebook

Related content:

EMS 12-Lead podast – Episode #1 – Syncope and sudden death in student athletes Part 1

2 Comments

  • VinceD says:

    Good discussion, but personally I'm still not on board for the use of general ECG screenings in patients without risk factors.
    A big question I have is just who will be reading the millions of ECGs that are performed across the country, as there most certainly are not enough electrophysiologists around and even pediatric cardiologists have been shown to have insufficient accuracy in this limited study (http://www.ncbi.nlm.nih.gov/pubmed/21752393). I can't imagine an adult cardiologist, emergency physician, or general practitioner looking to make some income on the side would fare better. Plus, the responsibility of shifting through at least a few hundred ECGs beloning to local pediatric athletes (two independent groups with difficult ECGs to interpret, let alone combined) to find the one with a fatal predisposition for cardiac arrest doesn't sound all that appealing to me, knowing that when one inevitably dies the hindsight of an expert witness will be judging whether you were respoonsible for missing what are often subtle and subjective signs.
    It's a topic where it is easy for emotion and headlines to affect decision making, but when a policy will be affecting millions of people and costing even more millions of dollars, rationality should really be the guiding force.

  • I've wondered if there is a role for "Web 2.0" (as a software engineer I die a little inside when I hear/use buzzwords like that) in a problem like this. Why not crowdsource (there it is again) the reading of the 12-Leads?

    Identify a pool of experienced electrocardiographers, probably through an online test with annual competencies, and have them evaluate some random subset of 12-Leads. If some threshold is met have a notification sent to the personnal physician of the patient to take a closer look at the ECG or request referral/follow-up.

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

JEMS Talk: Google Hangout

Comments
Colleen
68 y.o. male with weakness: “Treat the monitor, not the patient?”
Allergies? O2, combivent, Calcium. Repeat 12lead ekg. 2nd set of signs. Depending on 2nd Ekg and 2nd set of signs with combivent, reassessment of patient after interventions. Depending on reassessment, 2nd/3rd VS, and 2nd EKG, would determine my decision on where to transport. Per Massachusetts protocols.
2014-10-02 05:57:52
Billy Bob
68 y.o. male with weakness: “Treat the monitor, not the patient?”
Well I will lean with Dave and go with more education; this is a classic sine wave EKG and with more education hopefully we all could spot this from across the door because again as Dave said this is something rarely seen in EMS if at all; this is the ONE TIME I will advocate…
2014-10-02 02:49:58
david
68 y.o. male with weakness: “Treat the monitor, not the patient?”
Looks like sine wave. QRS >.15 tall peaked T waves prolonged PRI, indicative of hyperkalemia. Calcium, bicarbonate, 50% dextrose perhaps even some albuterol, insulin at the Ed
2014-10-02 02:44:55
Hollywood Mike
68 y.o. male with weakness: “Treat the monitor, not the patient?”
ALS weakness and fall. Mental status is such that he remembers falling. I'm not going to get all excited about this tracing. I'm treating the guy for his complaint and watching him like a hawk during transport. I've seen some aberrant conduction that makes this ECG look like NSR so I'm jaded by experience (need…
2014-10-02 01:51:00
PandaMedic
68 y.o. male with weakness: “Treat the monitor, not the patient?”
It's great to see so many different points of view and styles, it's sad that so many of us are being critical and condescending towards other practitioners. Dave has a point, in that more education is needed, but there is something to be said for everyone who is here, reviewing these case studies and actively…
2014-10-02 01:45:45

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