Cardiac arrest and deep T wave inversions

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The paramedic swung the stretcher into the resus bay, and started giving report. As the team of RNs, techs, and residents swung into action, I noted that the young adult patient didn’t look very sick at all. Confused, yes, and perhaps a bit anxious, but this seemed like an over-triage. “Paramedic Battistelli,” I called out, […]

Continuous Chest Compressions vs. 30:2. Does It Matter? Depends On the Quality!

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Seattle Fire Department Engine 2. The rescuer on the left has just placed a metronome on the ground. I will eventually get around to composing a more thoughtful blog post about my experiences at the Resuscitation Academy but in the interim I wanted to share something about the ventilation strategy in King County, Washington. There […]

The 12 Rhythms of Christmas: Paroxysmal AV-Block

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This article is the ninth in our latest series, The 12 Rhythms of Christmas, where we examine a different rhythm disorder with each new post. It’s a continuation of the theme behind last year’s 12 Leads of Christmas. And, just like last year’s series, I’m rather late getting the final articles out, but the end […]

71 year old male with “seizures” that prove to be ICD shocks

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EMS is called to the residence of a 71 year old male for “seizures.” On arrival the patient’s spouse meets the ambulance outside and hurries the paramedics along saying “Come quickly! Please help him!” The paramedics arrive at the patient’s side just in time to see him receive an ICD shock. They ask how long […]

90 year old female with abdominal pain and wide complex tachycardia

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EMS is called to the residence of a 90 year old female who awoke to an “uncontrolled bowel movement” that corresponded with sudden onset abdominal pain. On EMS arrival, the patient is alert and oriented to person, place, time, and event. She has a grimace on her face and appears acutely ill. When asked the […]

The 12 Rhythms of Christmas: High-Grade AV-Block

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This article is the eighth in our latest series, The 12 Rhythms of Christmas, where each day we examine a new rhythm disorder. It’s a continuation of the theme behind last year’s 12 Leads of Christmas. In our recent articles we’ve discussed three different types of AV-block that cause dropped P-waves: type I, type II, […]

The 12 Rhythms of Christmas: 2:1 AV-Block

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This article is the seventh in our latest series, The 12 Rhythms of Christmas, where each day we examine a new rhythm disorder. It’s a continuation of the theme behind last year’s 12 Leads of Christmas. Our last two posts have examined type I and type II AV-block, so it’s only fitting that we continue […]

The 12 Rhythms of Christmas: Type II AV-Block

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This article is the sixth in our latest series, The 12 Rhythms of Christmas, where each day we examine a new rhythm disorder. It’s a continuation of the theme behind last year’s 12 Leads of Christmas. Type II AV-Block Except for first degree,  type II is probably the simplest of the AV-blocks to identify. There’s […]

The 12 Rhythms of Christmas: Type I AV-Block

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This article is the fifth in our latest series, The 12 Rhythms of Christmas, where each day we examine a new rhythm disorder. It’s a continuation of the theme behind last year’s 12 Leads of Christmas. Before we delve into today’s particular rhythm I’d like to discuss a bit of terminology. My first ECG textbook […]

The 12 Rhythms of Christmas: First Degree AV-Block

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This article is the fourth in our latest series, The 12 Rhythms of Christmas, where each day we examine a new rhythm disorder. It’s a continuation of the theme behind last year’s 12 Leads of Christmas. An 84 year old male presents with a chief complaint of abdominal pain. The ECG below is performed: What […]

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