Author Archives: Tom Bouthillet

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 […]

Episode #8 – Jim Broselow, M.D. and the Artemis Pediatric Initiative – EMS 12-Lead podcast

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EMS 12-Lead podcast – Episode #8 – Jim Broselow, M.D.  In this episode of the EMS 12-Lead podcast we're joined by Jim Broselow, M.D., inventor of the Broselow Tape for pediatric resuscitation. We discuss the Broselow Tape as well as eBroselow.com, the Artemis Pediatric System and the SafeDose app. If you've been in EMS for […]

STEMI Recognition: Beyond the Basics – Register now!

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Coming soon! Register now for "STEMI Recognition: Beyond the Basics".  August 16, 2012 @ 2:00 p.m. (14:00) EST. Sponsored by Physio Control (thank you).  Direct link for registration is here.

EMS 12-Lead Podcast Episode #7 – PulsePoint

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  EMS 12-Lead Podcast – Episode #7 – PulsePoint In this episode of the EMS 12-Lead podcast we're joined by Richard Price of the PulsePoint Foundation. If you're not familiar with PulsePoint it used to be referred to as the San Ramon Valley Fire Department app. Richard Price PulsePoint Foundation Fire Chief, San Ramon Valley […]

65 year old male CC: Fall with injury – Conclusion

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This is the conclusion to 65 year old male CC: Fall with injury. You may wish to review the history and clinical presentation. When we left off the patient was in severe heart failure with the following 12-lead ECG. As we have mentioned before on several occasions, the most important thing when treating a patient […]

65 year old male CC: Fall with injury

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Here's a very interesting case submitted by a faithful reader who wishes to remain anonymous. Some changes have been made to preserve patient confidentiality. EMS is called to a local breakfast restaurant for a 65 year old male who fell in the parking lot. He was reported to have suffered a head injury. On arrival […]

Physio-Control demos how to incorporate the LUCAS into a "pit crew" approach to resuscitation

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Cam Pollock and John Friederich from Physio-Control put on a demonstration for us at Fire-Rescue Med 2012 to show how the LUCAS Chest Compression System can be incorporated into a "pic crew" concept for CPR and resuscitation. As you will see the application of the LUCAS device need not cause a significant delay in chest […]

Must-watch video of cardiac arrest save!

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This is an outstanding video that shows clips of an actual resuscitation and features a sudden cardiac arrest survivor. It's important to collect data so we can measure our progress and prove that we are saving lives, but as we build these systems of care we must always remember that these are our mothers, fathers, […]

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
Comments
David Baumrind
All that wiggles isn’t Wellens’
@Gary, by all means, nitpick all you like. I agree with your assessment, and the post has been modified. Thank you for the feedback!
2014-08-30 17:28:16
Gary Huntress
All that wiggles isn’t Wellens’
Not to nitpick but is this really a "slightly leftward axis"? I and AVF are both positive. I put it at about +20 degrees, not leftward.
2014-08-30 11:49:35
Handsome Robb
87 YOM COMPLAINING OF CHEST DISCOMFORT AND DYSPNEA
CHF. 12-lead shows a sinus Tachycardia in the 120s with PACs, besides the anterior leads there's diffuse ST depression, the STE in the anterior leads can be explained by the LBBB, axis is good as well. I wish they posted the EtCO2 waveform so we could see but I'm assuming it's non-obstructive. The elevated EtCO2…
2014-08-30 08:08:22
Christopher Watford
“Bad heartburn” – 82 y.o. female without chest pain.
Brooks, Firstly, thank you for the warm welcome to the club. Secondly, the Glasgow algorithm's only published sens/spec for AMI is 51.6%/97.6% respectively (Tuscon STEMI Database). I've not been able to find any other publications. The GE Marquette 12SL algorithm has been widely studied, but is much older, and ranges in sensitivity from 48% to…
2014-08-29 16:50:14
CB
57 Year Old Male–Chest Discomfort
Given what he was doing (paint fumes on ladder painting) I would first question if the pain is reproducable. Yes his ekg isn't normal but looks like old inferior MI. And he is hypertensive. 02 a must. Def. would give ASA. First would give morphine and see how his cp and bp are. If still…
2014-08-29 11:37:25

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