Tag Archives: STEMI

87 YOM COMPLAINING OF CHEST DISCOMFORT AND DYSPNEA

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 On a Thurday morning, approximately 02:15 hrs, in a small rural town, your EMS unit is dispatched to a residence for an 87 year old male with difficutly 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 […]

STEMI Mimics and STEMI Equivalents

Here’s my presentation from the VA EMS Symposium on 11/08/2013. STEMI Equivalents and STEMI Mimics from Tom Bouthillet

RBBB Abnormalities Missed

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The original presentation of this case appeared as  "What's Wrong with Mr. Wilson?"… You can read the original post here. Much has been written lately about RBBB abnormalities that were missed.  Dr. Smith has recently posted two cases here, and here discussing this. First, let's review the 12 lead of a typical RBBB. When learning […]

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 […]

53 Year Old Male: Severe Leg Pain–Conclusion

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This is the conclusion to 53 year old male: Severe leg pain. You may wish to review the case. Before we begin, my apologies for the delay in posting this conclusion. I live in coastal NY, and we got hammered by Hurricane Sandy. It has taken me a little time to get all caught up. […]

51 year old female CC: Near Syncopal Episode – Conclusion

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This is the conclusion to a 51 year old female CC: Near Syncopal Episode. If you haven't read the first part we highly recommend it! When we left off, our crew was attending to a 51 year old female who had almost passed out in a stadium tunnel during a college football game. We received […]

63 year old male CC: Substernal Chest Pain – Discussion

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This is the discussion for 63 year old male CC: Substernal Chest Pain, brought to you by Dr. Brooks Walsh of Mill Hill Avenue Command and Doc Cottle's Desk. Be sure to review the first part! When we last left off, our patient was a 63 year old male complaining of substernal chest pain which awoke […]

59 Year Old Male–"Lifting Boxes": Part II, with a twist!

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This is part II to 59 year old male–"Lifting Boxes". You may wish to review the case. Let's review the ECG: There is sinus rhythm at about 90 bpm. Some of you saw a slight bit of ST elevation in the inferior leads, and maybe an abnormal aVL. Perhaps? Perhaps not? V1-V4 look possibly abnormal, […]

Discussion for 51 Year Old Male: Chest Pain

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Here is the conclusion to 51 year old male: Chest Pain. You may wish to review the case. Here is the ECG again:   There is a regular sinus rhythm at a rate of about 70. The QRS is narrow. The axis is normal, at about 15 degrees. Let's take a look at the constellation […]

"What Happened?"–Discussion

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This is the discussion to "What Happened?" You may wish to review the case here. Ok, let's review the initial 12 Lead: Just about everyone picked up on the infero-posterior STEMI. Where it got interesting for me, was determining what the rhythm was! At first glance, the rhythm was for the most part regular (note […]

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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