Category Archives: patient-management

Masters Case #01: 50 Year Old Male – Severe Chest Pain

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Most of our cases here at EMS 12-Lead are designed to strike a balance between challenging experienced prehospital providers while also highlighting a couple of specific teaching points for those seeking to learn. It’s a difficult line to walk. We want to showcase EKG’s with specific findings that are apparent enough to make good teaching […]

70 Year Old Male: Short of Breath

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  Good morning sports fans! You are dispatched to the residence of a 70 year old male, complaining of “shortness of breath”. You pull up to a well kept home, and are met at the front door by the patient’s wife. She tells you that her husband came home from the hospital yesterday after cosmetic […]

“Push Hard, Push Fast?”

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“Push Hard, Push Fast” We all know the mantra. It’s catchy. Compressions not deep enough? Push hard. Not fast enough? Push fast. Great. Except… One thing many of us have learned as professional rescuers is that the bigger issue is not pushing too slow, but pushing too fast. “But…push FAST!” I mean, faster has to […]

When to stop: Termination of Resuscitation in Pediatric Traumatic Cardiac Arrest

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Field termination of pediatric resuscitation is a difficult topic for EMS systems, prehospital providers, first responders, and the patient’s family. Clear guidelines exist for the termination of resuscitation of adults in cardiac arrest for both traumatic and non-traumatic etiologies, and routine transportation of adults in cardiac arrest all but guarantees poor outcomes.¬†Unfortunately, for pediatric patients […]

74 Year Old Male: Chest Discomfort

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  It’s a sunny winter afternoon when you and your partner are called to a local doctor’s office for an “adult male- possible heart”. When you arrive, you are led into room #3 where you find a 74 year old male, in no apparent distress. His color looks good. You introduce yourself, and find out […]

Conclusion to Snapshot Case: 44 Year Old Male – Chest Tightness

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This is the conclusion to the Snapshot Case located here. You may want to review the initial description again. As many readers correctly pointed out, this patient is experiencing a STEMI. Let's start with the basics and work our way up to some pretty advanced topics. First, there is anterior ST-elevation with upwardly-concave T-waves, as […]

All that wiggles isn’t Wellens’

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   This is the discussion for our Snapshot Case involving a 45 year old female complaining of chest pain. Here is the 12 lead for review:                           There is sinus rhythm at about 75 bpm, with a slightly leftward axis. Slight ST elevation […]

Snapshot Case: 44 Year Old Male – Chest Tightness

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Here's a new "Snapshot" case courtesy of Dr. Bojana Uzelac from Serbia… A 44 year old male presents with a chief complaint of tightness in his chest x 1 hour. He was on his way to a conference when it started and states: "It feels kind of like asthma. I've never been diagnosed but I […]

Snapshot Case: 45 Year Old Female–Chest Pain

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  Here is the latest from our "Snapshot" case collection..  This ECG was taken from a 45 year old female patient who had "off and on" chest pain for about 24 hours. The discomfort radiated to her left arm, and she complained of some "dizziness".  She denies any associated SOB, or N/V.  The discomfort worsened over […]

63 Year Old Female, CC: Neck and Arm Pain–Discussion

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  This is the discussion for our recent case 63 Year Old Female, CC: Neck and Arm Pain. Let's revisit the 12 Lead ECG: There "appears" to be a Sinus Brady rhythm at a rate of about 52 bpm, with a first degree AVB. The rhythm is regular for the first half of the ECG, then […]

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