Author Archives: Tom Bouthillet

The most awesome STEMI test on the internet!

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Senior Editor Christopher Watford created an online STEMI test based on McCabe JM, et al. Physician Accuracy in Interpreting Potential ST-Segment Elevation Myocardial Infarction Electrocardiograms. J Am Heart Assoc. 2013; 2:e000268. It was in beta testing for a while (see this thread at EMTLife.com) but apparently it is now ready for prime time! I say that […]

Pit Crew CPR – The Explicit Details

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I’ve given an overview of my department’s Pit Crew CPR process many times at ems12lead.com, our Facebook page, the Resuscitation group, and various conferences around the country. (See also: Why do we send so many people to a cardiac arrest?) Even so, I’m frequently asked for specific details. People want to know exactly how we do it. […]

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 […]

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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Proficiency vs Deficiency… The Art Of Electrocardiography | EMS 12 Lead
Understanding Amiodarone
[…] on the highlighted title for an Amiodarone breakdown, UNDERSTANDING AMIODARONE   One tool I use in these cases of bradycardia, is SPo2 monitoring. Remember, with every systole […]
2015-05-22 16:59:43
Wayne
12 Lead ECG – Lead Placement Diagrams
I have been doing EKG's for the past thirty years. It use to be that you always lay the patient in the supine position but here lately I have been told that with the patient sitting up right will not change the EKG, is this so ?
2015-05-21 17:37:37
Ivan Rios
Understanding Atropine
Hi Tony, thank you for writing. It's always a bit of a gamble to give opinion in such topics without being there, however, addressing ventilation is a must. The rate could be secondary to vagal stimulation and/or respiratory depression, but it sounds like the patient is compensating pretty well when it comes to the hemodynamic…
2015-05-21 12:55:43
Tony Correia
Understanding Atropine
Looking for an opinion. Had a pt. who was unconscious from unknown etiology, Agonal respiration = 6, SPO2 = 59, heart rate =37 sinus bradycardia, B/P = 137/80 . We ventilate the pt. approx for 2 minutes without change in status. Would you have administered atropine or continue with BVM to attempt to correct hypoxia,…
2015-05-21 12:16:26
dan
57 year old male: Chest Discomfort
I'm sorry but I don't see any flutter here. With a rate of 150 we are at the very upper limit of sinus tach. No O2 is indicated with a pulse ox of 94%, especially if you are thinking cardiac. Place in position of comfort, large bore IV, fluid bolus, ASA, nitro, capnography, complete assessment…
2015-05-14 03:50:36

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