Tag Archives: inappropriate concordance

64 year old female CC: Trouble Breathing – Conclusion

Entry Img

Lots of great comments and it was good to see the depth of discussion on the appropriate treatment and transport for this patient! This is the conclusion to 64 year old female CC: Trouble Breathing. When we left off our crew was attending to an elderly female patient in respiratory extremis. Pulmonary edema was present […]

Sgarbossa's Criteria – New Graphic

Entry Img

Here is a graphic I created to help explain Sgarbossa’s criteria for identifying acute myocardial infarction (AMI) in the presence of left bundle branch block (LBBB) or paced rhythm. In a previous article I showed this graphic which was created using PowerPoint. Here is a similar graphic I created this morning by cropping actual ECGs […]

Found on the Lifenet Receiving Station

Entry Img

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 […]

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

Entry Img

In Part I, we discussed Sgarbossa’s Criteria for identifying AMI in the presence of LBBB. We also talked about the “rule of appropriate T wave discordance” for bundle branch blocks and other forms of abnormal depolarization (like ventricular rhythms or paced rhythms). You will recall that I drew a distinction between a QRS complex’s main […]

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

Entry Img

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 […]

EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
Comments
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
Joseph Goodson
The 360 Degree Heart – Part I
As a new Paramedic, this information is very useful and helpful. I believe there is more to understanding paramedicine than what can be taught in a class and it takes the initiative of the medic to pursue. Thank you for providing this simple yet understandable concept. Honestly, it never dawned on me how the hexaxial…
2014-09-13 15:27:21
Author Unknown
The Part We Forget
The Part We Forget
The Real Problem With Ray Rice
The Real Problem With Ray Rice
Techno:  Could Be Time
Techno: Could Be Time
Labor: Leave Ray Rice Alone
Labor: Leave Ray Rice Alone

STEMI Expert?

  • Click here to find out!
  • 12-Lead ECG Challenge Smartphone App

    Photobucket

    12-Lead ECG Challenge Smartphone App - $5.99

  • Apple iOS
  • Android
  • Amazon
  • Web Based

  • FRN-TV video review
  • iMedicalApps.com review
  • Interested in resuscitation?

    FireEMS Blogs eNewsletter

    Sign-up to receive our free monthly eNewsletter

    Visitor Map / Stats

    Locations of visitors to this page


    LATEST EMS NEWS

    HOT FORUM DISCUSSIONS