Author Archives: Christopher Watford

Revisiting Transcutaneous Cardiac Pacing

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“Transcutaneous cardiac pacing is an effective procedure for patients experiencing unstable bradycardia.” Or is it? If you’ve read Tom’s introduction to the subject of false capture you’re already ahead of the game. We’ve shown case after case of unstable bradycardia patients receiving ineffective transcutaneous pacing due to a lack of capture. In each case, phantom pacing impulses […]

59 year old male: chest pressure – Conclusion

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The conclusion has been combined with the original case study. http://www.ems12lead.com/2014/04/18/59-year-old-male-chest-pressure/

Subtle STEMI, New Right Bundle Branch Block, and Cardiac Arrest

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It’s a hot summer night in the suburbs, most of which you’ve spent on standby for a local baseball game. After clearing up you’re put on a chest pain call a few blocks from your quarters. The local volunteer fire department has a squad on scene which is advising you to, “continue on emergency.” Upon […]

When to stop: Termination of Resuscitation in Pediatric Traumatic Cardiac Arrest

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Field termination of pediatric resuscitation is a difficult topic for EMS systems, prehospital providers, first responders, and the patient’s family. Clear guidelines exist for the termination of resuscitation of adults in cardiac arrest for both traumatic and non-traumatic etiologies, and routine transportation of adults in cardiac arrest all but guarantees poor outcomes. Unfortunately, for pediatric […]

Understanding ECG Filtering

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A common problem in ECG interpretation is the removal of unwanted artifact and noise. To help with this our cardiac monitors provide a means to filter the ECG recording. Most cardiac monitors will choose the appropriate filter based on the situation. When performing routine monitoring, where only the cardiac rhythm is important, the filters applied are known […]

77 year old female CC: Abdominal Pain

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It's a quiet Sunday afternoon when you're dispatched to a residence for a 77 year old female complaining of abdominal pain. Your dispatch notes indicates she was at the ED the day prior. Upon your arrival, you're met on the porch by the patient's son who directs you inside. Your patient is sitting in a […]

47 year old male: Holiday Indigestion – Conclusion

This is the conclusion to 47 year old male: Holiday Indigestion. Thanks go to a long time reader Nicholas Eisele for this holiday case! Editor's Note: sorry for the delay, it helps to press "publish"! When we left off, our patient was in the back of the truck with a burning sensation radiating to his […]

47 year old male: Holiday Indigestion

Thanks go to a long time reader Nicholas Eisele for this holiday case! As always, details have been changed to protect patient privacy. It is a blustery Christmas morning when you and your partner are dispatched for a 47 year old male with chest pain. Firefighters are already on scene obtaining a history and vitals […]

Name that ECG: 66 year old female – Findings

This is the conclusion to our Name that ECG case: 66 year old female, resolved chest pain. 66 year old female, resolved chest pain.   Rhythm: Rate: atrial rate of ~55 bpm, ventricular rate of ~55 bpm Regularity: regular P-waves: sinus (upright in I and II), associated 1:1 with the QRS PRi: 140 ms QRS […]

Name that ECG: 66 year old female

Welcome to another installment of Name that ECG! Remember, this is a cold read and your job is to interpret the ECG to its fullest. 66 year old female, resolved chest pain.   Rhythm: Rate? Regularity? P-waves? PR interval? Associated? QRS width? Bonus points: Axis? QTc? ST/T-wave changes? What are your differentials? Posts which include any […]

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