Code STEMI Web Series – EMS 12-Lead Podcast Episode #6

EMS 12-Lead podcast – Episode #6 – Code STEMI Web Series (Special Episode)

As you probably already know if you've been following EMS 12-Lead or First Responders Network on Twitter or Facebook, we're working on a new web series called Code STEMI.

We just got back from AHA Scientific Sessions 2011 in Orlando which was our first location. We met some incredibly passionate people and had some amazing experiences! 

Ted Setla, Jamie Davis and I discussed it on a special episode of the EMS 12-Lead podcast.

Ted Setla
Executive Producer of the Code STEMI Web series
Setla Films
First Responders Network

Jamie Davis
Executive Producer of the EMS 12-Lead podcast
MedicCast
ProMed Network

The first teaser for the series has also been released at the First Responders Network.

Click HERE to watch.

Chris "the Dridge" Eldridge, Ted Setla and Tom Bouthillet
at AHA Scientific Sessions 2011

2 Comments

  • Jack Bode says:

    I've been a medic for over 31 years and the recent pre-hospital recognition, treatment and proper dispositions of the STEMI patient has been the best thing since portable defibrillators.
    My department has been doing this for about 5 years and I have some thoughts and advice born of experience.
    1. Don't expect a boat-load of STEMI patients. I work in a large metro area, do about 1100-1200 runs personally a year, and see about three STEMI's.
    2. Train the medics to actually read the EKG. Don't waste time and money on telemetry.
    3. Allow the medics to activate the cath lab from the field. No gatekeepers – NONE.
    3. Give the medics hard rules about when they can activate the Cath-Lab.Ours are:
         a. ST elevation> 2mm or more in 2 contiguous leads
         b. Patient having chest pain and monitor indicated "acute MI"
         c. No blocks. QRS duration of 120 ms or less.
    4. Expect false cath lab activations. The occurance will drop over time. Ours is under 10%.
    5. Hammer home the education, make it a continuing project.
    The development of STEMI protocols and the introduction of devices such as the Lucas has made this most exciting time to be involved in EMS. Good luck on your project and thanks for your passion. I can't think of a more worthy endeavor.

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
Comments
Jeff
Rate Related VS. Primary ST-T Changes:
He's complaining of 10/10 chest pain that coincided with palpitations with a HR of 206 that is probably A-Fib. I am guessing that if you correct his rate you will allow his myocardium to become perfused again and his chest pain will subside. I would pre-sedate him with Midazolam 2mg and electrically cardiovert starting @…
2014-09-21 19:17:36
Michael
Rate Related VS. Primary ST-T Changes:
I just don't see adequate evidence for WPW. I would be confident administering this PT Cardizem at .25mg/kg based on his hemodynamic stability. I'd also like to know more about PT history, like does he have AFIB at baseline and, if so, what does he take for it. I would also ask about a history…
2014-09-21 12:06:31
Tony
59 year old male: chest pressure – Conclusion
Thank you Christopher. I am wondering if this particular patient is one of the minority where the LCx is the dominant artery supplying the Posterior and Inferior regions. I believe this to be the case in only about 15% of the population. Whereas approx. 80% are Right dominant.
2014-09-21 08:39:21
John
Rate Related VS. Primary ST-T Changes:
ECG is a rapid atrial fibrilation with ventricular rates approaching 300 beats per minute suggestive of WPW. Widespread ST segment depression is most likely rate related ischemia; elevation in aVR is not a reliable finding with a rapid heart rate point away from LMCA occlusion. Slow the rate before looking for ischemia, injury, or infract.…
2014-09-21 01:49:03
Sean V
Rate Related VS. Primary ST-T Changes:
Also forgot to mention decrease the FiO2, 3LPM is getting us a SpO2 of 98%, titrate down so we staying at or above 94%. No need to hyperoxygenate & create all those fun free radicals. I would also include using an EtCO2 nasal cannula, lets get another measure of our cardiac output.
2014-09-20 02:32:20

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