Tag Archives: inappropriate concordance

64 year old female CC: Trouble Breathing – Conclusion

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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

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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

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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 […]

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

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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

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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
Ethan Camden
Appropriate Cardiac Cath Lab Activation: Optimizing ECG interpretation and clinical decision making for acute STEMI
Hello - can you please send me the link to the full article published on Ivan Rokos, M.D., relating to Indications for Cath Lab activation (from 2010, AJH) ? Thanks! Ethan
2014-08-25 11:10:49
Conclusion to 80 Year Old Male: Fall | EMS 12 Lead
80 Year Old Male: Fall
[…] is the conclusion to 80 Year Old Male: Fall. If you do not remember the particulars, check out the original post and then come back here to […]
2014-08-25 09:34:45
Billy Bob
“Bad heartburn” – 82 y.o. female without chest pain.
Well shame on me I just read the conclusion (no RVI and it was indeed a LCX).
2014-08-25 02:06:49
Billy Bob
“Bad heartburn” – 82 y.o. female without chest pain.
I'm a bit late and curious to read the conclusion (coming after this) I agree with all and again to beat the dead horse but yes I agree with 12 leads in the setting of GI symptoms (specifically here) as it is quite common to have "heart burn" as the C/C for IWMI due to…
2014-08-25 02:01:05
Bryan Laviolette
“Bad heartburn” – 82 y.o. female without chest pain.
misread the BP, apologies
2014-08-24 21:18:42

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