Tag Archives: reciprocal changes

Contiguous and reciprocal lead charts

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Here are some charts to help you identify and localize acute STEMI on the 12 lead ECG. Contiguous leads What do we mean when we say leads are “contiguous”? Contiguous leads are “next” to one another anatomically speaking. They view the same general area of the heart (specifically the left ventricle). For example, these states […]

EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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Comments
Brian Brubaker
59 Year Old Male: Unwell
At a quick glance it looks like tombstones (R on T). At closer look without calipers, it appears to be accelerated ideoventricular rhythm due to complete heart block. Not enough information to go off of, so cardioverting or pacing might just kill the patient quicker than anything. Transport immediately since his sick heart could stop…
2015-07-02 05:49:02
Holden
59 Year Old Male: Unwell
I've only studied cardiology for a few months and have read Dubin's book 1.5 times so I'm not an expert by any means. However, can a possible interpretation be a junctional tachycardia with aberrant ventricular conduction and a STEMI? No P waves and aberrancy causing a slightly wide QRS (but not wide enough for V-Tach).
2015-07-02 00:50:22
James
59 Year Old Male: Unwell
This is a ugly EKG. Wide complex irregular tachycardia around 150's. A-fib and a-flutter are possibilities. He's severely symptomatic. At this point, all treatment is same, electricity. If A fib, it may not want to "shock out" easily. This may be a case where initial cardioversion at max joules would be prudent. Pulmonary edema likely…
2015-07-01 22:00:13
Bryan
59 Year Old Male: Unwell
Calcium has little to no side effects, given the first EKG I think it is reasonable to consider it for first line treatment. Repeat EKG after 5 mins and reassess.
2015-07-01 21:14:40
Mike MacKenzie
The Trouble with Sinus Tachycardia
An absolute must read for all Medics. Great article. I am always trying to tell students to consider referring to these fast rhythms as a narrow complex tachycardia, then start looking for the cause, be it physiologic response or an electrical conduction issue. And as many have stated, I often hear that it must be…
2015-07-01 20:11:34

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