Tag Archives: Syncope

Syncope and sudden death in student athletes – EMS 12-Lead podcast Episode #1

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EMS 12-Lead podcast – Episode #1 – Syncope and sudden death in student athletes. Tom Bouthillet, David Baumrind and Christopher Watford are joined by Dr. John Mandrola from the Dr. John M blog. We discuss sudden death in student athletes, the controversy surounding the prescreening of student athletes, the need for AEDs in the schools, […]

17 year old male CC: Syncope – Discussion

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This is the discussion for 17 year old male CC: Syncope. You may wish to go back and familiarize yourself with the details of the case. Let's take another look at the 12-lead ECG. It wasn't that long ago that I was trying to convince paramedics to perform 12-lead ECGs on chest pain patients. I […]

17 year old male CC: Syncope

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EMS is called to a local restaurant on a very hot day for a 17 year old male patient who experienced a syncopal episode. On arrival the patient meets the ambulance in the parking lot and says, "Hey, man, I'm really sorry. We don't need the ambulance."  Paramedics asks what happened and he says, "I […]

13 year old female CC: Syncope – Discussion

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This is the discussion for 13 year old female CC: Syncope. You may wish to go back and familiarize yourself with the details. The short of it is that on a very hot and humid day a 13 year old female passed out after looking at her sister's scraped knee. She had passed out at […]

13 year old female CC: Syncope

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EMS is called to a local hardware store for a 13 year old female with a possible seizure. On arrival the patient is found sitting outside at a picnic table. Her mother and father are both present. The ambient temperature is hot and humid. The patient's skin is very warm and moist but chalky. Her […]

Holiday Heart at 510 Medic

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I’m not sure if I ever formally recommended the 510Medic blog authored by Patrick Lickiss at 510Medic.com, but he’s been in my blogroll for some time now. He’s also one of the contributors to the burgeoning EMS Research podcast. It’s an excellent EMS blog that deserves to be followed and read, so please check him […]

63 year old male CC: Syncope

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He denies chest discomfort, palpitations, or shortness of breath.

37 year old male CC: Unconscious

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EMS is called to evaluate an unconscious 37 year old male. En route to the scene dispatch advises paramedics that the patient is now conscious and may have experienced a syncopal episode and seizure-like activity. The spouse believes that the patient may be having a stroke. On arrival the patient is found lying in bed. […]

66 year old male CC: Syncope x3

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You are dispatched to an "unknown medical complaint." En route to the scene, dispatch advises you that a 66 year old male is complaining of a fall with injury, chest pain, left arm pain, and nausea. On arrival, the patient is standing in his kitchen. He is pale and extremely diaphoretic. You direct him to […]

EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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Comments
Jared
59 Year Old Male: Unwell
Field Dx: Uncompensated cardiogenic shock. Tachycardia caused by compensation mechanism. Probable cause: Complete heart block due to the global nature of the changes. Tx: O2 @ 15 lpm NRB and possibly CPAP if pressure rises enough, 324 ASA, amio drip, possible norepi, and diesel. Put pads on in case he tanks. Definitive Tx: Needs cathed.
2015-07-02 17:46:57
Jonas
59 Year Old Male: Unwell
CPAP. IV. Nitro if BP can be controlled. Kidneys may be in acute failure causing extra fluid, or CHF, or both. Big ole triangular looking t-waves would have me thinking calcium. Monitor to see if conditions improve with CPAP. Place pads on patient, and have help with you in the ambulance.
2015-07-02 17:17:30
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

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