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"Treat the patient not the monitor?"- Redux

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  "For heaven's sake man, treat the patient not the monitor!"  Ahh, the angry cries appear every time we post a difficult case with a challenging ECG or treatment decision.. The attitude seems intractable, despite our best efforts. Over a year ago, I wrote "Treat the Patient not the Monitor?", and not much has changed […]

49 Year Old Male: Chest Pain

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  This excellent case comes to us from our friends in the UK. The author wishes to remain anonymous, but we thank him for his contribution. It is about 8am on a gorgeous Wednesday morning, when your Paramedic unit is dispatched to a 49 year old male, "chest pain". You arrive at the bungalow of […]

RBBB Abnormalities Missed

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The original presentation of this case appeared as  "What's Wrong with Mr. Wilson?"… You can read the original post here. Much has been written lately about RBBB abnormalities that were missed.  Dr. Smith has recently posted two cases here, and here discussing this. First, let's review the 12 lead of a typical RBBB. When learning […]

77 year old female CC: Abdominal Pain

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It's a quiet Sunday afternoon when you're dispatched to a residence for a 77 year old female complaining of abdominal pain. Your dispatch notes indicates she was at the ED the day prior. Upon your arrival, you're met on the porch by the patient's son who directs you inside. Your patient is sitting in a […]

Survivor gives us a lens into regional systems of care for acute ischemic stroke in North Dakota

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I just got back from the North Dakota Mission: Lifeline STEMI and Acute Stroke Conference in Bismark, ND. I had a great time and I learned a lot. I often get asked to speak in various venues about acute STEMI and 12-lead ECG interpretation, but for this conference they wanted me to talk mostly about […]

The Trouble with Sinus Tachycardia

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  Sometimes recognizing sinus tachycardia can give us fits. What? Sinus tachycardia? One of the most basic rhythms? The discussion that follows will highlight some of the difficulties sinus tach can present at high rates. The pitfalls of using the generalized term "SVT" will also be discussed. This discussion is not meant to imply that […]

Episode #11 – Are we harming patients with oxygen?

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EMS 12-Lead Podcast – Episode 11 – Are We Harming Patients With Oxygen? In this episode of the EMS 12-Lead podcast we’re joined by Kelly Arashin, ACNP, CCNS and Mike McEvoy, PhD, RN, CCRN, REMT-P at EMS Today 2013 in Washington D.C. We discuss the benefits and dangers of oxygen administration. Kelly is a dual […]

Code STEMI – London Ambulance Service

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Ivan Rokos, M.D. has referred to primary PCI for acute STEMI as “the most complex, multi-disciplinary, and time-sensitive therapeutic intervention in the world of medicine.” The emphasis on door-to-balloon times, and more recently, first medical contact or EMS-to-balloon times has transformed how acutely ill patients suffering heart attacks receive timely reperfusion in many communities, because […]

Code STEMI Web Series – London to premier at EMS Today in Washington, D.C.

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Seaon 2 of the Code STEMI Web Series is set to launch on March 7, 2013 at EMS Today in Washington, D.C.! This season starts out with our most exciting location ever — London, England as we feature the London Ambulance Service (LAS). You can follow the series at First Responders Network or at CodeSTEMI.tv. […]

47 year old male: Holiday Indigestion – Conclusion

This is the conclusion to 47 year old male: Holiday Indigestion. Thanks go to a long time reader Nicholas Eisele for this holiday case! Editor's Note: sorry for the delay, it helps to press "publish"! When we left off, our patient was in the back of the truck with a burning sensation radiating to his […]

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