63 year old male CC: Shortness of breath

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By request I'm trying something new. The 12-lead ECG will be cropped and the computerized interpretation removed until the solution is posted. Let me know if you find this approach to be useful. This is how I used to teach 12-lead ECG interpretation but I started leaving the computerized interpretation because that's reality — you'll […]

ECG Challenge – Is it a STEMI?

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Since you all seemed to enjoy the link I posted to the ACC's ECG Challenge from 2006 I thought I'd give you another ECG Challenge. I'm working on a special project (details to be announced soon) and I came across this interesting ECG from the archives of an old computer. I thought it was long […]

Part 1 of the Conclusion to 15 year old male CC: fall from vehicle

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This is Part 1 of the conclusion to 15 year old male CC: fall from vehicle. Lots of great comments, including an unexpected sidebar discussion on appropriate C-spine clearance! All of our cases on EMS 12-Lead have been altered from their original form to protect patient and provider privacy and it appears I changed things […]

15 year old male CC: fall from vehicle

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It has been a busy afternoon as the local schools are out for the Thanksgiving holiday. You've shift traded to get a longer vacation and are working with a newer paramedic. It's not long after dinner when you're paged out for a motor vehicle collision with an ejection. The details are hazy, but first responders […]

Conclusion to "41 Year old female: chest pain"

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This is the conclusion to 41 year old female: chest pain. I think we would all agree the patient presentation is suspicious for ACS. Let's review the first 12 Lead: The rhythm is sinus tach. There is about 1mm of ST elevation in V1, and depending on where you spot your J point, little to […]

Automated compression device war turns hardcore

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I received an email from a ZOLL rep this morning that had a file attachment called "AutoPulse Technical Report #3". The report shows a crash test with a mannequin outfitted with either the AutoPulse or the LUCAS compression device. Wouldn't you know it? The LUCAS device lost. Ladies and gentlemen: the gloves are off!

How much should an ear ache cost?

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Photo credit: Kelly Arashin I had a very relaxing and restorative trip up to northern Michigan last week with my family. The weather was perfect. There was sightseeing in national forests, campfires and s'mores, good wine, good stories, and some hard work constructing a drainage system on the side of my parents' log home on […]

41 Year Old Female: Chest Pain

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Here's an interesting case sent in by faithful reader Carl R. Christiansen, Paramedic, from Norway. As usual, changes have been made to protect patient confidentiality. It's an early Sunday morning when you are dispatched to a hotel for a 41 year old female with chest pain.  You and your partner enter the hotel room and […]

64 year old male CC: Indigestion – Discussion

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This is the discussion to 64 year old male CC: Indigestion. If you recall, we had a stubborn gentleman complaining of indigestion with a significant cardiac history. Considering the symptoms kept our patient awake, are highly suggestive of a coronary event, and we have uncompensated hypotension, we should have a keen interest on any ECG […]

Fun and games with response time reporting

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As I've mentioned on several different occasions, it's a huge mistake to wait until a tragedy occurs to explain the truth about response times to your community. Response times should be measured from the patient's perspective. In other words, from the moment the dispatcher picks up the phone and says, "9-1-1 what is your emergency?" […]

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