Author Archives: Tom Bouthillet

Why do we send so many people to a cardiac arrest?

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I did a fair amount of traveling and teaching in 2013 and I've been struck by the number of people who have been gobsmacked by the number of rescuers my fire department sends to a sudden cardiac arrest (1 ambulance, 2 engines, and a battalion chief). I think there are several reasons for this. In […]

STEMI Mimics and STEMI Equivalents

Here’s my presentation from the VA EMS Symposium on 11/08/2013. STEMI Equivalents and STEMI Mimics from Tom Bouthillet

Survivor gives us a lens into regional systems of care for acute ischemic stroke in North Dakota

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I just got back from the North Dakota Mission: Lifeline STEMI and Acute Stroke Conference in Bismark, ND. I had a great time and I learned a lot. I often get asked to speak in various venues about acute STEMI and 12-lead ECG interpretation, but for this conference they wanted me to talk mostly about […]

Episode #11 – Are we harming patients with oxygen?

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EMS 12-Lead podcast – Episode #11 – Are we harming patients with oxygen? In this episode of the EMS 12-Lead podcast we're joined by Kelly Arashin, ACNP, CCNS and Mike McEvoy, PhD, RN, CCRN, REMT-P at EMS Today 2013 in Washington D.C. We discuss the benefits and dangers of oxygen administration.  Kelly is a dual […]

Code STEMI – London Ambulance Service

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Ivan Rokos, M.D. has referred to primary PCI for acute STEMI as “the most complex, multi-disciplinary, and time-sensitive therapeutic intervention in the world of medicine.” The emphasis on door-to-balloon times, and more recently, first medical contact or EMS-to-balloon times has transformed how acutely ill patients suffering heart attacks receive timely reperfusion in many communities, because […]

Code STEMI Web Series – London to premier at EMS Today in Washington, D.C.

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Seaon 2 of the Code STEMI Web Series is set to launch on March 7, 2013 at EMS Today in Washington, D.C.! This season starts out with our most exciting location ever — London, England as we feature the London Ambulance Service (LAS). You can follow the series at First Responders Network or at CodeSTEMI.tv. […]

New Infographic: Left Anterior Fascicular Block (LAFB)

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Since infographics are all the rage nowadays I thought we'd put some together for ECG interpretation. I'm starting with left anterior fascicular block… well, just because! I hope you find these to be useful! See also: Left anterior fascicular block

Episode #10 – Brooks Walsh, M.D. from Mill Hill Ave Command

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EMS 12-Lead podcast – Episode #10 – Brooks Walsh, M.D. from the Mill Hill Ave Command blog  In this episode of the EMS 12-Lead podcast we're joined by Brooks Walsh, M.D., Emergency Physician and Editor of Mill Hill Ave Command and Doc Cottle's Desk. We discuss paramedic education, ECGs, blogging, science fiction doctors, "treating the patient […]

Episode #9 – Thomas Concannon, ph.D. talks about regionalization of STEMI care and the proliferation of PCI hospitals in the United States

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EMS 12-Lead podcast – Episode #9 – Thomas Concannon, ph.D. talks about the regionalization of STEMI care and the proliferation of PCI hospitals in the United States In this episode of the EMS 12-Lead podcast we're joined by Thomas Concannon, ph.D., Assistant Professor of Medicine at Tufts Medical Center and Tufts University School of Medicine. […]

The early repolarization experiment

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Any paramedic who has studied the STEMI mimics has heard of the classic benign early repolarization pattern of a "fish-hooked" J-point with upwardly concave (smiley-faced) ST-segment, often best appreciated in lead V4. But, as the excellent work of Stephen Smith, M.D. demonstrates, not all cases of early repolarization present this way, and it can often […]

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