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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 […]

74 year old male with chest discomfort, right bundle branch block, and ST-segment elevation

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It’s a sunny winter afternoon when EMS is called to a doctor’s office for “an adult male with possible heart problem.” 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 that your patient was […]

All that wiggles isn’t Wellens’

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. Slight ST elevation in V2. Biphasic T wave inversion in V2, inverted T waves in aVL, V3-V5. As we recall, the patient had complained of […]

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 […]

63 Year Old Female, CC: Neck and Arm Pain

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  Good morning. It's 7:45 am on a sunny winter Monday, and you are just finishing up your holiday shopping list– it is getting down to the wire after all! The tones go off, and you are dispatched to the residence of a 63 year old female, "sick".  You arrive to a well kept two […]

Why do we send so many people to a cardiac arrest?

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I did a fair amount of traveling and teaching in 2013 and I’ve been struck by the number of people who have been amazed by the number of rescuers my fire department sends to a sudden cardiac arrest (1 ambulance, 2 engines, and a battalion chief). I think there are several reasons for this. In […]

The Weekend Roundup: ECG Highlights from Around the Web…

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37 Year Old Male–CC: Chest Pain, Part II

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This is part II to “37 year old male–CC: Chest Pain“. You may wish to review the case. So, while many of our cases are straightforward, this one is not. But hey, our patients don’t read the textbooks! First, let’s review the chief complaint: Our 37 year old male had “chest tightness”, but complained of lethargy […]

37 Year Old Male- CC: Chest Pain

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This excellent case comes to us from Paramedic Jack Buckle. Thanks Jack! You and your partner are in the middle of a busy shift, when you are dispatched to 37 year old male complaining of chest pain. It's almost 2pm, and a balmy 78 degrees. You arrive to a well kept house and find your […]

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