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58 Year Old Male, Workout Worry

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  Your Paramedic crew is called to the home of a 58 year old male, “possible heart” Upon arrival to the home, you are greeted by the gentleman’s wife, who directs you to your patient. You find him sitting in a chair in the living room, appearing concerned, but in no serious distress. He tells […]

71 Year Old Male: Chest Discomfort- Discussion

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Here is the discussion for “71 year old male: chest discomfort” let’s review the prehospital 12 lead:     Here are the precordial leads blown up:   There is slight ST elevation in V1,  ST elevation in V2 (saddleback morphology), as well as slight ST elevation in V3 and V4. The STE in V3 and V4 […]

71 year old male: Chest Discomfort

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  This very interesting case comes from Bryan F, a Paramedic from Long Island. A 71 year old male is cooking breakfast when he experiences sudden onset of 10/10 chest discomfort. He waits 20 minutes or so for it to subside, but it does not and he calls 911. EMS arrives to find him lying […]

Rapid Prehospital Evolution of STEMI

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82 year old male, in good physical shape, stops at a cafe for lunch after cycling for an hour. Witnesses report a syncopal episode lasting approximately 30 seconds. Patient history significant for prior MI requiring 3 stents. No other significant history. Patient denies any CP, SOB, N/V, lightheadedness. In fact, he denies any complaints at […]

Snapshot Case- No Day at the Beach

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It is a beautiful summer afternoon when you and your partner are called to the beach for a “swimmer in distress”. Upon your arrival, you find a 48 year old male sitting on a beach towel, appearing to be in some distress. You are told that he was swimming in the ocean when he began […]

High Performance CPR – Performance Not Protocol!

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[Español] This is a supplement to Adult Pit Crew CPR and Pediatric Pit Crew CPR. Specifically, this is how we have modified our training process since attending the Resuscitation Academy in Seattle / King County. Each rescuer should experience each position at least twice. In other words, you run the drill, stop and switch, run the drill, […]

“Seizures” prove to be recurrent arrhythmias with multiple ICD shocks

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EMS is called to the residence of a 71 year old male for “seizures.” On arrival the patient’s spouse meets the ambulance outside and hurries the paramedics along saying “Come quickly! Please help him!” The paramedics arrive at the patient’s side just in time to see him receive an ICD shock. They ask how long […]

“You Make the Call” — 86 Year old Female: Dizzy

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  It is a beautiful September morning when the tones go off for a 86 year old female, “altered mental status”. “Guess breakfast will have to wait”, as you and your partner head towards the residence. As you enter the one level home, you are directed to a back bedroom where you find your patient […]

Rate Related VS. Primary ST-T Changes:

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A 56 year old black male presents to the Emergency Department via EMS, complaining of Chest Pressure, 10/10 pain scale. Pain started suddenly following sudden onset of palpitations, while mowing his lawn. All approximately 5 minutes prior calling EMS. Keep in mind, it was a hot and sunny day with temperature in the 90’s. He advised of prior episodes of chest pressure […]

57 Year Old Male–Chest Discomfort

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  It is a bright Sunday morning when you and your partner are dispatched for an “adult male-chest pain”. You arrive at a well kept residence, noting a ladder and paint cans as you enter. You find your patient, a 57 year old male, sitting on the sofa in mild distress. “I was doing some […]

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