Author Archives: Tom Bouthillet

73 year old female CC: Chest pain – Conclusion with angiograms

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Here is the conclusion to 73 year old female CC: Chest pain. I’m sorry the conclusion to this case took so long. Due to a clerical error I received a duplicate case. Let’s take another look at the 12-lead ECG. The patient was emergently cathed and a partially occlusive thrombotic lesion was identified in the […]

It's not too late to help Lt. Matt McDowell and FF David Rice!

I wrote about this previously and I pledged $50.00 which I donated by using this link to Bluffton Township Fire District’s webpage, and I’m hoping you will consider doing the same. In case you didn’t know, Lt. Matt McDowell is the author of the S.A.F.E. Firefighter blog and his daughter Juliann will be born with […]

Jamie Davis, Peter Canning, and Tom Bouthillet discuss waveform capnography on the Innovations in Patient Care podcast

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Innovations in Patient Care podcast sponsored by Physio-Control. Jamie Davis, Peter Canning, and Tom Bouthillet discuss waveform capnography. Part I Part II Subscribe to the Innovations in Patient Care podcast on iTunes here.

Using capnography to confirm capture with transcutaneous pacing (TCP)

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Those of you who have been following me for a while (here and other online forums) know that I have searching for cases where a patient was successfully paced with a Lifepak 12. I have reviewed dozens of cases where the treating paramedic thought the patient was being paced, but the rhythm strips showed only […]

58 year old male CC: Chest pain

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Here’s an interesting case sent in by a faithful reader who wishes to remain anonymous. EMS is called to the residence of a 58 year old male complaining of chest discomfort. On arrival the patient is found sitting on the edge of the bed. He is anxious but alert and oriented to person, place, time, […]

Rhythm Challenge #5 – Answer

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As I explained in Evaluating the Pacemaker Patient – Part I, most modern pacemakers are DDD pacemakers according to the NBG pacemaker code.

Rhythm Challenge #5

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@S_Cook_EMTP contacted me on Twitter with regard to a 77 year old male with an interesting heart rhythm. He subsequently took a picture of the ECG and emailed it to me with this description: 77 yo male with history of COPD, CHF. Initial 4-lead EKG reveals A-Flutter with variable response: 2:1, 3:1, 4:1, and 5:1 […]

Early bird gets the worm

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As Ambulance Driver would say, “For all you EMS types, my latest column is up at EMS1.com.” Early bird gets the worm Enjoy!

Cardiac Arrest – Anatomy of a System Failure

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Dave Statter (STATter911.com) recently posted a story about a cardiac arrest that occurred in Ocean City, MD. It’s a sad story with an unhappy ending. In fact, there’s only one redeeming quality about this story. It’s a perfect example of a system failure. The dispatcher who answered the 9-1-1 call “froze” and was unable to […]

Conclusion to 43 year old female CC: Chest pain – Angiograms

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Here is the conclusion to 43 year old female CC: Chest pain. Let’s take another look at her 12-lead ECG. This patient experienced cardiac arrest on arrival in the emergency department. She was defibrillated while still on the EMS gurney, stabilized, and then transferred to the cardiac catheterization lab. Here we see a proximal occlusion […]

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