Author Archives: Vince DiGiulio

Is epinephrine harmful in cardiogenic shock?

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We’re only going to focus on one facet of today’s article in our discussion, but Dr. Sean van Diepen wrote an excellent editorial that covers several other important points. [1] There is more to the paper than I’m going to dive into here, so check out his editorial if you have access around the paywall. […]

In Defense of Morphine (Part 2)

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Yesterday, I introduced some of the history preceding the recent Thrombosis and Haemostasis study looking at morphine in patients experiencing ST-elevation myocardial infarctions (STEMIs). [For the curious, we’ll talk about that new article in Part 3. I have to work today, so I can’t guarantee that it’ll be up tomorrow, but soon!] We started with […]

In Defense of Morphine (Part 1)

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Every time I hope this debate is going to die out, or that science will swing back toward rationality, another study gets published and throws a wrench in things. I’ll type this very carefully: There is no convincing evidence that morphine causes harm to patients experiencing ST-elevation myocardial infarctions (STEMIs). As long as there isn’t […]

50 Year Old Male: Chest Pain, Hypotension, Pulmonary Edema (Conclusion)

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This is the conclusion to Friday’s post. If you haven’t seen it, I suggest checking out the original patient presentation and ECG first. We have reproduced this case courtesy of Dr. Musa A. Sharkawi (@MusaSharkawi on Twitter). A 50-year-old man presented with sudden-onset chest pain, respiratory distress, pulmonary edema, and hypotension. This was his ECG: […]

50 Year Old Male: Chest Pain, Hypotension, Pulmonary Edema

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Physician and cardiovascular fellow Dr. Musa A. Sharkawi shared this ECG on Twitter (@MusaSharkawi) and has graciously allowed us to reproduce it here. A 50-year-old male presents with a chief complaint of abrupt-onset severe chest pain. He is pale, diaphoretic, and ill-appearing—in moderate respiratory distress with extensive biateral crackles and a low blood pressure. Further […]

Triaging Triage ECGs

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I’ve spent nine years working in an emergency department, which means I’ve also spent nine years performing electrocardiograms at triage. With a couple thousand waiting-room ECGs under my belt, I’ve noticed a few things: A lot of ECGs are ordered at triage. Many of them are performed on low-risk patients. Very few of those ECGs […]

ECG Mixtape: Vol. 2

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Welcome to the second installment in our ECG Mixtape series! It looks like this will be an irregular publication while we streamline our process of picking cases and getting permission to reproduce them. Enjoy! Pick of the Week This weeks top pick comes from cardiologist Dr. Gianni Manzo in São Paulo, Brazil, who shared this […]

ECG Mixtape: Vol. 1

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Welcome to the start of a new series here at EMS 12-Lead. With the ECG Mixtapes we’ll compile some of the week’s best ECG’s from around the world of social media and #FOAMed. As High Fidelity taught us, “The making of a great compilation tape, like breaking up, is hard to do and takes ages […]

59 Year Old Female: Intermittent Head Pain (Conclusion)

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This is the conclusion to Wednesday’s post; if you haven’t seen it, I highly suggest checking out the original case description and initial ECG. Wednesday’s case introduced a 59 year old woman with a chief complaint of intermittent occipital head pain for about 10 days. Recently, it had started radiating into her neck and upper […]

59 Year Old Female: Intermittent Head Pain

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One of my co-workers told me that she wants to see more case studies. A 59-year-old female presents to the emergency department with a chief complaint of “head pain that comes and goes.” She describes the pain as a dull ache in her occiput that’s been striking without warning a couple of times per day […]

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