Tag Archives: sgarbossa’s criteria

Just a paced rhythm… Or is it? Conclusion

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Ok, so I posted a 12 Lead ECG on Facebook this past Monday, June 2nd, 2014, which  generated some interesting comments and thoughts… EMS 12-Lead on Facebook: 67yom with Dyspnea and Diaphoresis  This ECG was obtained from a 67 year old male, complaining of difficulty breathing for the past 2 hours, and presented diaphoretic, with […]

Discussion for 70 Year Old Male: Short of Breath

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This is the discussion for “70 Year Old Male: Short of Breath“. Tough case. Lots of excellent comments and observations from our readers. Right off the bat, the patient’s presentation offered a major distraction: the recent eye surgery resulting in the old “eye patch presentation”. Confounding the situation further was the lack of any cardiac […]

87 YOM COMPLAINING OF CHEST DISCOMFORT AND DYSPNEA

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  It’s a sunny morning, and your EMS unit is dispatched to a residence for an 87 year old male with difficulty breathing.   You arrive on scene before the fire engine and enter the residence. Upon entering the bedroom, you find an elderly male, sitting on the edge of the bed, vomiting. He is alert and oriented x 4 (person, […]

2013 STEMI Guidelines: EMS is Accountable

On Monday, the American College of Cardiology Foundation and the American Heart Association released the 2013 Guidelines for the Management of ST-Elevation Myocardial Infarction. Their last updates to these guidelines were in 2004 and 2006, so this is an important milestone. If you have been following our blog and podcast, most of the changes will […]

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 […]

88 year old female CC: Chest pain – Conclusion

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This is the conclusion to 88 year old male CC: Chest pain. Let's take another look at the 12-lead ECG. This ECG shows acute STEMI in the presence of left bundle branch block. It's also an excellent example of the value of using "excessive discordance" to identify acute STEMI in the presence of left bundle […]

50 year old male CC: Chest pain – Discussion

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This is the discussion for 50 year old male CC: Chest pain. You may recall that the patient started experiencing chest pain during sexual intercourse. Many of you were appropriately concerned about the possible use of drugs for erectile dysfunction that would contraindicate nitroglycerin! Thanks for pointing that out. In this case the patient was […]

80 year old male CC: Chest pain – Conclusion

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This is Part II of the conclusion to 80 year old male CC: Chest pain. For Part I see Excessive discordance as a marker of acute STEMI in LBBB. First, let's take another look at the initial 12-lead ECG. The first thing that catches my eye in this ECG is the strange morphology of the ST-segments […]

Excessive discordance as a marker of acute STEMI in LBBB

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Positively deflected QRS complexes can be expected to show ST-depression and inverted T-waves.

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. […]

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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Comments
Vince DiGiulio
Transcutaneous Pacing Success!!! Part 2
Thanks! I've yet to have a chance to check heart tones during TCP but I'll try to make it a priority next time to see how well it works for me.
2015-03-30 04:37:42
Snapshot Case: 85yo M – Chest Pain | EMS 12 Lead
Conclusion to Snapshot Case: 85yo M – Chest Pain
[…] UPDATE: Conclusion to this case. […]
2015-03-29 19:54:59
Jake
47 year old male CC: Crushing chest pain
I know this is old, but it just popped up on facebook so I'll go ahead and put in my $0.02 worth. With that hx and that 12-lead, there's no question this is an acute STEMI. I'm comfortable calling that third strip Torsades (assuming I've verified it's not an equipment issue). The defib pads are…
2015-03-24 14:14:19
Ngan Thanh
17 year old male CC: Syncope
I thinks about WPWs on ECG!
2015-03-21 23:27:41
bob
Adenosine for sinus tachycardia: Try to avoid this!
I have a better answer for Shay's patient (and Mel) and it's called lone a-flutter because I just had it diagnosed in me. I'm looking at my ekg showing a rate of 230 which fooled the doc who thought it was svt's until I told him I had no history of anything and talked him…
2015-03-21 21:57:17

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