Tag Archives: EKG

Understanding ECG Filtering

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A common problem in ECG interpretation is the removal of unwanted artifact and noise. To help with this our cardiac monitors provide a means to filter the ECG recording. Most cardiac monitors will choose the appropriate filter based on the situation. When performing routine monitoring, where only the cardiac rhythm is important, the filters applied are known […]

65 year old male CC: Fall with injury – Conclusion

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This is the conclusion to 65 year old male CC: Fall with injury. You may wish to review the history and clinical presentation. When we left off the patient was in severe heart failure with the following 12-lead ECG. As we have mentioned before on several occasions, the most important thing when treating a patient […]

Comparing 12-Leads: Discussion

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This is the discussion for Comparing 12-Leads: Common Error or Common Disease? All of our readers were on the right track, and many were spot on! Sometimes, troubleshooting an ECG is more than just lead placement. In this case report, we had three 12-Lead ECG's, all featuring a similar pattern: inappropriate R-wave progression. Initially, when […]

88 year old male CC: Chest pain – Conclusion

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This is the conclusion to 88 year old male CC: Chest pain. You may wish to go back and review the history and clinical presentation. First, let's look at the rhythm strip. This shows an undetermined regular rhythm at a rate of about 60 with demand ventricular pacing.  This is an oversimplification but as long […]

88 year old male CC: Chest pain

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EMS is called to a 88 year old male with a chief complaint of chest discomfort. On arrival the patient meets EMS at the front door. His skin is slightly pale and moist. He appears anxious. Past medical history: "Cardiac", pacemaker, hypertension, dyslipidemia Medications: Numerous, unavailable at the time of EMS evaluation Paramedics lead the […]

64 year old female CC: Trouble Breathing

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Thanks go to Michael Herbert for this great case! As always, some details have been changed to protect patient privacy. It’s late into your shift when the tones go off for breathing problems at a local extended care facility.Enroute you’re advised it is a 64 year old female with a “low O2 sat,” and to, […]

90 year old male CC: "Possible stroke"

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EMS responds to a 90 year old male with a "possible stroke". On arrival the patient is found sitting on the toilet (lid down). His spouse states that he had walked outside to retrieve the newpaper when he lost his balance and skinned his knee. She helped him inside and sat him down on the […]

83 year old male CC: "Cardiac patient in distress"

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EMS is dispatched to a "cardiac patient in distress". On arrival paramedics are led to the bathroom where the patient is found sitting on a foot stool. He is conscious but appears acutely ill. Skin is pale and he is slumped over. He states that he feels weak. Past medical history: High blood pressure, high […]

Conclusion to 88 year old male CC: Chest pain

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This is the conclusion to 88 year old male CC: Chest pain. You may wish to review the previous post for the history and clinical presentation. Let's take another look at the 12-lead ECG. Now with the computerized interpretation. This 12-lead ECG shows bifascicular block and is very suspicious for acute STEMI. The first thing […]

88 year old male CC: Chest pain

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EMS is called to the residence of a 88 year old male patient with a chief complaint of chest pain. On arrival the patient is found standing at the front door. He appears anxious and acutely ill. Skin is pink and warm but diaphoretic. The patient is led to a kitchen chair and the assessment […]

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
Comments
Keren Levi
The 360 Degree Heart – Part I
Lately, a few paramedic-students arrived at my station. So i tried to explain that basics at my best simpliest way. After readinv your perfectly coherent "article", i couldnt stop smily for knowing we both thought of same phrases and associatives words. For me it is a great compliment! Thanks for writing! Cant wait for part…
2014-09-17 19:34:44
Richard Kenkel
64 y.o. Female with CP – “And then I gave her a NTG…”
Cardiac arrest? Its a RELATIVE contraindication. You need to use clinical gestalt. Her blood pressure is quite high, and her heart rate is average, she would probably tolerate nitro quite well. Provided she's not on beta blockers or calcium channel blocker, orthostatic hypotension etc, from what I can tell she'd compensate just fine. While there…
2014-09-16 02:05:12
Stephen Smith, of Dr. Smith's ECG Blog
59 year old male: chest pressure
Inferolateral MI, not RV (T-wave down in V1)
2014-09-14 18:16:53
Alex
The 360 Degree Heart – Part I
Some models of ECG machines have an option to flip aVR upside down. In this case it looks at +30* and fills in the gap between I and II.
2014-09-14 16:00:21
Lucas
59 year old male: chest pressure
Besides MI and Aortic Dissection, this presentation of acute chest pain and hemodynamic compromise, associated with important dyspnea would concern me for PE, which I think should be properly investigated.
2014-09-14 14:35:36
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