Tag Archives: Identifying AMI in the presence of LBBB

An unusual case of left bundle branch block – Discussion

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It turns out this patient was experiencing a STEMI.

80 year old male CC: Chest pain

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Here’s a case submitted by a faithful reader who wishes to remain anonymous. It’s a great case and destined to be one of my favorites! EMS is called to evaluate a 80 year old male patient with a chief complaint of chest pain. On arrival the patient is found sitting on his living room couch. […]

58 year old female CC: Chest pain

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Here’s another case study from an international reader who wishes to remain anonymous. Presenting Complaint – Chest Pain History of Present Complaint – 58 year old female, nil cardiac history, mild smoker, social drinker and overweight. Complaining of acute central chest pain @ rest. Awoken by pain. On Arrival – Sat upright on settee (Editor’s […]

62 year old male CC: Chest pain

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62 year old male presents to the emergency department complaining of chest discomfort. Past medical history is significant for dyslipidemia and ulcerative colitis. Also prior history of significant tobacco use. Maternal history of CAD. Maternal and paternal history of CVA. The patient’s only medication is Lipitor but he took an aspinin en route to the […]

Found on the Lifenet Receiving Station

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Is there anything about this ECG (other than the poor data quality) that interests you? The patient was a 90 year old male, fall with injury. Also complaining of pain between the shoulder blades. *** UPDATE *** This ECG caught my eye because it satisfies one of Sgarbossa’s criteria for the identification of AMI in […]

EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

JEMS Talk: Google Hangout

Comments
Nathan
68 y.o. male with weakness: “Treat the monitor, not the patient?”
Much more worried about HYPERkalemia than hypokalemia. Extreme wide QRS + Peaked T Wave is strongly indicitive of HyperK
2014-10-02 14:55:20
Nathan
68 y.o. male with weakness: “Treat the monitor, not the patient?”
This is huuuugely wide. Thinking hyperkalemia. Start with Calcium. Not going to hurt anything with it - and may save the patient.
2014-10-02 14:40:52
steve
68 y.o. male with weakness: “Treat the monitor, not the patient?”
I have seen this before except it was worse. Based on 3 diuretics and presence of wide bizarre ecg I would go with hyperkalemia . This pt requires electrolyte balancing not a PCI My pt presented Brady, hypotensive , simular morphology ecg with pauses and did not respond to fluid atropine or pacing ended up…
2014-10-02 14:01:53
Colleen
68 y.o. male with weakness: “Treat the monitor, not the patient?”
Allergies? O2, combivent, Calcium. Repeat 12lead ekg. 2nd set of signs. Depending on 2nd Ekg and 2nd set of signs with combivent, reassessment of patient after interventions. Depending on reassessment, 2nd/3rd VS, and 2nd EKG, would determine my decision on where to transport. Per Massachusetts protocols.
2014-10-02 05:57:52
Billy Bob
68 y.o. male with weakness: “Treat the monitor, not the patient?”
Well I will lean with Dave and go with more education; this is a classic sine wave EKG and with more education hopefully we all could spot this from across the door because again as Dave said this is something rarely seen in EMS if at all; this is the ONE TIME I will advocate…
2014-10-02 02:49:58

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