57 year old male: Chest Discomfort

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The following is a great case from Mordy E, and as always some details have been changed to protect patient privacy. You and your partner are refueling your ambulance at a gas station when a woman walks up and asks if you could, "come check out my husband." As you walk over to their car […]

88 year old female: Weakness – Discussion

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This is the discussion for 88 year old female: Weakness. If you've not read the backstory, we suggest you check it out! When we last left off, our patient was in an exam room with an irregularly irregular rhythm. The ED physician had asked you if the patient had a history of atrial fibrillation. Let's […]

88 year old female: Weakness

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This great case was submitted by Vince DiGiulio, EMT-CC; we highly recommend you read his wonderful blog The Medial Approach to Emergency Medicine. As usual, the case has been altered to protect patient and provider privacy. You're working triage in a busy urban ED when an 88 year old female is brought in by her family. […]

59 Year Old Male: "Lifting Boxes"

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This is part one of today's case study. As usual some information has been changed to protect patient confidentiality. EMS is called to the residence of a 59 year old male, who's chief complaint is chest discomfort.  As the crew enters the kitchen, they find the patient sitting in a chair surrounded by family members. […]

Episode #9 – Thomas Concannon, ph.D. talks about regionalization of STEMI care and the proliferation of PCI hospitals in the United States

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EMS 12-Lead podcast – Episode #9 – Thomas Concannon, ph.D. talks about the regionalization of STEMI care and the proliferation of PCI hospitals in the United States In this episode of the EMS 12-Lead podcast we're joined by Thomas Concannon, ph.D., Assistant Professor of Medicine at Tufts Medical Center and Tufts University School of Medicine. […]

The early repolarization experiment

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Any paramedic who has studied the STEMI mimics has heard of the classic benign early repolarization pattern of a "fish-hooked" J-point with upwardly concave (smiley-faced) ST-segment, often best appreciated in lead V4. But, as the excellent work of Stephen Smith, M.D. demonstrates, not all cases of early repolarization present this way, and it can often […]

Snapshot Discussion: 64 Year Old Male–Chest Pain

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This is the discussion for "Snapshot: 64 Year Old Male–Chest Pain". First, let's talk about the patient presentation.What is concerning is the substernal chest pain, radiating to the shoulder and neck area. While this occurred about 30 minutes after exercise, it did not occur during exercise, so that is somewhat atypical. Still, enough red flags […]

77 year old female: Unresponsive – Discussion

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This is the discussion for 77 year old female: Unresponsive, if you have not read the case report we recommend you start there! First, a hat tip to our readers who were unafraid to tackle this challenging scenario. Second, we were very impressed to see a number of readers correctly identify this challenging rhythm! When we […]

77 year old female: Unresponsive

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This is a great case sent in my a reader who wishes to remain anonymous. We hope you find it as intriguing as we did! After clearing up from a routine interfacility transfer, you're dispatched for a 77 year old female who is unresponsive at a local extended care facility. A BLS engine crew is […]

Snapshot: 64 Year Old Male–Chest Pain

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Today we have a short "Snapshot" case…Just the down and dirty. You are called to an urgent care center for a 64 year old male, CC of substernal chest pain, which radiated to the right shoulder and neck area. He states the discomfort feels a little like "indigestion". This episode began just after finishing a […]

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