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
Dominic
Conclusion to 59 Year Old Male: Unwell
Great discussion on a difficult 12lead! I follow these very closely and based on pt presentation and 12lead tracing, this was a difficult or to treat with impending heart failure, hypotension, and trouble breathing. Thanks for the follow up and look forward to next week!
2015-07-06 20:53:35
Billy
Conclusion to 59 Year Old Male: Unwell
Hmmmm, I was fairly close. Sounds like most of the treatment occurred IN Hospital. Love case studies, and that one was good.
2015-07-06 20:28:25
Kori
59 Year Old Male: Unwell
There's the point! There is are no P waves, and the rhythm is irregulary-irregular-atrial fibrillation. If you look, it is rsR phenomen-RBBB, BUT there are huge ST elevations on all leads from V1-V5 (that's why the QRS complexes look so broad). I and aVL is clearly ST elevation suggesting STEMI. In limb leads you can…
2015-07-06 10:12:16
Vince DiGiulio
Conclusion to 59 Year Old Male: Unwell
I'll expand on this in the next post but unfortunately I actually wasn't present for this case so I can't give my direct account of how things happened. That said, from the notes I read and word-of-mouth from those involved (which I suspect painted things in a better light than I would have viewed them),…
2015-07-06 04:09:22
Matt King
Conclusion to 59 Year Old Male: Unwell
Hey Vince thanks for the through follow up with this case. I am curious how his rate was controlled since he was hypotensive and maybe an unknown onset of when his A-Fib stated(thinking anticoagulation first)? As you know the wrong approach could be devastating in this PT with risks of further infarction, stroke, or death…
2015-07-05 14:10:57

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