Tag Archives: cardiac arrest

59 year old male: chest pressure – Conclusion

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This is the conclusion to 59 year old male: chest pressure, be sure to read the case study first! When we left off, we’d loaded our 59 year old male patient with 10 of 10 chest pressure into the back of our unit with the help of a local volunteer EMT. The patient appeared acutely unwell […]

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 […]

47 year old male CC: Crushing chest pain – Conclusion

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Here is the conclusion to 47 year old male CC: Crushing chest pain. You may want to go back and read the original case presentation to see how we got to this point. When we left off we had this rhythm on the monitor and surprisingly the patient was conscious and talking!  As usual there […]

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?" […]

Conclusion to 60 year old male CC: Sudden cardiac arrest

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This is the conclusion to 60 year old male CC: Sudden cardiac arrest. As you may recall the resuscitation was implemented using Adult Pit Crew CPR. This is not meant to miminize the importance of the chain-of-survival, including early activation of 9-1-1 and bystander CPR. Those links were intact for this case and that is extremely […]

60 year old male CC: Sudden cardiac arrest

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Here's a great case submitted by a faithful reader who wishes to remain anonymous. Some minor details have been changed to preserve patient confidentiality and some relevant comments and teaching points have been added. EMS is called to a barbecue festival for 60 year old male, unconscious and unresponsive, possible cardiac arrest. En route dispatch […]

Wake County EMS cardiac arrest survival rate among the highest in the country

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via NBC 17 News In these trying economic times, wouldn't it be nice to enjoy these bragging rights? It's not so easy for elected officials to cut your budget when you can prove you're a vital public service!  It feels good to save people, too. As noted by the panelists of the HeartRescue Project at […]

High Performance CPR – Seattle Style!

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Editor's note: Since it's all over the news that Seattle's "save rate" for cardiac arrest (witnessed collapse, presumed cardiac etiology, shockable rhythm) is over 50%, I asked Dave Hitlz of the HEARTsafe Community page on Facebook if I could re-post an article he and Mathias Duschl wrote about their experience at the Resuscitation Academy. He […]

91 year old female CC: Seizure (A strange situation) – Discussion

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Here is the 12-lead ECG that was captured just as she went into cardiac arrest.

56 year old female with a "cardiac disorder"

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Here’s an interesting case submitted by Mike from Massachusetts. Here’s the story in Mike’s own words: EMS is contacted by a local rehabilitation facility for a female patient with a cardiac disorder. Initial dispatch is an ALS ambulance, ALS squad, and a BLS engine company. Approximately 20 minutes prior to EMS arrival, patient began experiencing […]

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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Comments
Joe
Snapshot Case: What Happened?
Pt has some wicked bi-phasic T-waves s/p defibrillation...
2015-05-27 04:01:32
Greg
Snapshot Case: What Happened?
Unsynced cardioversion! I mirror the comments above wondering why this patient even required cardioversion for this afib as the rate doesn't seem particularly sinister. And after 4 shocks maybe consider that the afib might not respond at all and focus on other treatment avenues.
2015-05-27 02:56:05
Sam
Snapshot Case: What Happened?
The patient appears to have been unintentionally cardioverted during the relative refractory period, which can send the heart into v-fib. The first attempt looks to be 50J, under the 120J usually recommended for rapid a-fib, and did not work. Before the second attempt, it appears that there is no longer capture and the patient was…
2015-05-26 23:51:11
Wes Comstock
Snapshot Case: What Happened?
Great example of what happens if you dont sync prior to cardioversion, but I think it is also worth mentioning that its highly unlikely that this patients symptoms were rate related. In the top strip the rate was approx 114 over the 10 seconds and just prior to shock #5 the rate was right around…
2015-05-26 23:17:39
Justin White
Snapshot Case: What Happened?
After shock #4 they didn't sync the monitor again after it defaulted back to defib. They shocked on the T-wave.
2015-05-26 22:47:07

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