Author Archives: Vince DiGiulio

Spot the STEMI #1

Entry Img

You have a 50/50 shot at getting this one right. Are you feeling smart… or lucky? Two 50-year-old men present complaining of chest pain x 1 hour. One patient is suffering from a very subtle acute STEMI while the other has a non-cardiac cause for his chest pain. Which patient is experiencing the subtle STEMI? […]

Conclusion to 43 Year Old Female – Chest Discomfort After Eating

Entry Img

This is the conclusion to our case from last Saturday. I suggest reviewing the original case presentation before diving into the discussion here. A 43-year-old female presents feeling like there’s a knot behind her sternum. It began suddenly just after eating lunch. This is her initial ECG: There is apparent ST-elevation in leads V1–V3. The […]

43 Year Old Female – Chest Discomfort After Eating

Entry Img

You respond to an office workplace for a 43-year-old female with a chief complaint of chest discomfort. On arrival you are greeted by the patient who is pleasant and well-appearing. Her skin is warm, pink, and dry and pulse strong at the radials. Respiratory effort is normal with clear lung sounds bilaterally and she does […]

Conclusion to 59 Year Old Male: Unwell

Entry Img

This is the conclusion to our latest case, 59 Year Old Male: Unwell. I suggest starting there and reviewing the scenario before diving into this discussion. I was glad to see our latest case generated quite a bit of debate. This is a difficult tracing coupled with an equally difficult clinical scenario, so it wasn’t […]

59 Year Old Male: Unwell

Entry Img

**UPDATE** The conclusion to this case is now posted here. It’s the middle of the afternoon when you are dispatched to the residence of a 59 year old male with a chief complaint of general illness. When you arrive on scene you encounter a middle-aged man in obvious distress, lying on a couch. He is […]

What If We’re Wrong? Prehospital ECG Interpretation

Entry Img

This article is part of a special one-day EMS blogging event called the What If We’re Wrong a-Thon. Spearheaded by Brandon Oto over at EMS Basics, the WIWWAT is an exercise in self-reflection where EMS writers examine a topic on which that they’ve historically taken a strong stance, but from the opposite point-of-view. For more […]

Snapshot Case: What Happened?

Entry Img

Snapshot cases are tracings where we do not have good patient follow-up—or sometimes even clinical information—but still feel there are points worth discussing.   This is a patient who required emergent cardioversion for unstable rapid atrial fibrillation. What happened?   Tracing shared by Rob McDonald, and emergency department nurse in Queensland, Australia.

Transcutaneous Pacing Success!!! Part 2

Entry Img

This is the second half of a two-part case presentation examining transcutaneous pacing. If you didn’t see yesterday’s post I highly suggest checking out Part 1 before continuing, but if you hate learning I suppose you can start here. Yesterday we examined a series of tracings that depicted transcutaneous pacing (TCP) in all its stages: […]

Transcutaneous Pacing Success!!! Part 1

Entry Img

Anyone trained in transcutaneous pacing (TCP) needs to be able to identify the rhythm below instantly. It shows a patient being transcutaneously paced at 80 bpm and 125 mA on a LifePak 12 [the strip is labelled 130 mA but that refers to a point just past the end of the paper, I promise]. Well, […]

The 12 Leads of Christmas: V3

Entry Img

This is the eleventh and penultimate article in our latest series, The 12 Leads of Christmas, where each day we examine an individual electrocardiographic lead. Lead V3 Today we’re going to discuss V3, and there’s no way I can do that without talking about isolated posterior myocardial infarction. Of all twelve, fifteen, eighteen, or even […]

Page 3 of 612345...Last »