Tag Archives: Syncope

Conclusion to 80 Year Old Male: Fall

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This 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 find the “answer” and summary. Case Review You arrived on scene to meet an 80 year old patient who was found on the floor after suffering what […]

80 Year Old Male: Fall

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A previously well 80-year-old experienced a fall at his home where he lives alone. He was walking from the living room to the kitchen when suddenly he found himself on the ground, which he attributes to tripping on the runner rug in the hallway. “My son has been telling me to get rid of that […]

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 patientmay be having a stroke. On arrival the patient is found lying in bed. He […]

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
Comments
Sean V
Rate Related VS. Primary ST-T Changes:
Also forgot to mention decrease the FiO2, 3LPM is getting us a SpO2 of 98%, titrate down so we staying at or above 94%. No need to hyperoxygenate & create all those fun free radicals. I would also include using an EtCO2 nasal cannula, lets get another measure of our cardiac output.
2014-09-20 02:32:20
Sean V
Rate Related VS. Primary ST-T Changes:
Atrial Fibrillation w/ Rapid Ventricular Response. There appears to be possible Delta Waves, the most prominent being in aVL, also leads I, II, and V6. In the EMS 12-Lead there appears to be a fusion beat, 3rd in V2, slurred R-wave appears quite consistent with a Delta wave. I would consider WPW as the primary…
2014-09-20 02:28:16
Brian
Rate Related VS. Primary ST-T Changes:
Afib. There is widespread depression in most leads and aVR has some elevation...but I am skeptical about this ecg. If a quick fluid challenge of 500-1000cc did not slow down the HR I would give him some diltiazem (5mg increments is our protocol or 0.25mg/kg) and slow the rate down a bit and see if…
2014-09-19 21:02:48
Michael Schiavone
Rate Related VS. Primary ST-T Changes:
Isolated ST elevation in AVR with ST depression in several leads. Rapid, irregular rate suggests AFIB with RVR. I would provide entry note with this exact description and leave it to hospital whether or not to activate cath lab. My EMS treatment: IV access, 324 mg. ASA, NTG, Cardizem .25 mg/kg over 2 minutes, consider…
2014-09-19 20:30:35
Dayne
Rate Related VS. Primary ST-T Changes:
AF with RVR @167, LVH and prolonged QT. ST depression to I,II and V3-6 and reciprocal elevation to aVR equal to or >1mm highly suggestive of LMCA or 3-vessel disease. High specificity for proximal occlusion. Aspirin, GTN, IV access, Spo2 >95%, Transport to nearest PCI/Cath Lab facility ASAP
2014-09-19 10:52:36

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