Tag Archives: bundle branch block

58 year old male CC: Chest pain

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Here’s an interesting case sent in by a faithful reader who wishes to remain anonymous. EMS is called to the residence of a 58 year old male complaining of chest discomfort. On arrival the patient is found sitting on the edge of the bed. He is anxious but alert and oriented to person, place, time, […]

Identifying STEMI in the presence of LBBB – Sgarbossa's Criteria – Part I

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There has been a lot of discussion lately about identifying AMI in the presence of LBBB (see Dr. Bearemy’s “My Emergency Medicine Blog” here and a recent thread on the EKG Club). I’ve also been receiving a lot of emails offlist, so I think a full discussion is in order. In my recent post Who […]

Computerized interpretive statements and bundle branch blocks

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Here’s an ECG that I’ve used in my 12 lead class for many years. It’s usually good for a laugh! I show this ECG right after I teach students to identify LBBB on the 12 lead ECG. I explain that it was captured on an emergency call for a 80 year old male who was […]

EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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Comments
Erik
What If We’re Wrong? Prehospital ECG Interpretation
In my paramedic class we were taught to pay attention to the numbers generated by the monitor, but you can never trust them. You must examine the rhythms in each lead and look for appropriate elevations along with reciprocal depressions. And this is not a time consuming event. I will say that in my city…
2015-08-05 01:13:26
EMS Artifact
Nitro paste is NOT an emergency medicine drug – The Evidence
Interesting post. As you point out, nitropaste is ineffective in treating acute CHF. Of all the treatments I used over the years for this, CPAP is by far the best. That is followed by NTG spray, which my system started using in the late 1980s when it was first available. Our protocol then (and now)…
2015-08-05 00:22:18
michelle
68 Year Old Male: Chest Tightness – Part 1
i see some depression and slight elevation in the st segment in the avr. i would alert the stemi crew to stand by.
2015-07-27 17:15:03
sean morrison
68 Year Old Male: Chest Tightness – Part 1
It's the big one Weezy! LAD
2015-07-27 12:48:03
Ryan Lord
68 Year Old Male: Chest Tightness – Part 1
Had the exact same last night but a known AF patient pain commenced after 2 hours of palpitations and described as like a previous MI. Her rate was up at around the 160 mark... Had the widespread depression but elevated aVR and V1. Discussed with Cath Lab and preceded to A&E next door for review,…
2015-07-27 12:14:23

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