EMS 12-Lead

David Didlake, NRP, APRN, ACNP-BC @DidlakeDW Expert analysis provided by Dr. Ken Grauer https://ecg-interpretation.blogspot.com/ @ekgpress EMS is called to the main reception area of a retirement center where an elderly female is found down, unconscious and unresponsive. She has a palpable pulse at the radial arteries, bilaterally, with shallow respirations. This particular facility is situated for independent living, thus no medical providers are on site to provide pertinent

David Didlake, NRP, APRN, ACNP-BC @DidlakeDW Peer review provided by Dr. Steve Smith @smithECGblog A 55 y/o Male presents to a freestanding urgent care center with chest discomfort, left arm pain, nausea, and diaphoresis. He reports to staff that for the past two months, approximately, he has experienced intermittent dyspnea on exertion when walking the dog, particularly when scaling an incline. He admits to a mostly sedentary lifestyle, however denies any smoking, orthopnea,

David Didlake, NRP, APRN, ACNP-BC This case is provided by C. Madden, Paramedic. Many thanks for sharing! A 48 y/o Male called 911 after experiencing sudden onset chest discomfort while performing yard work. He presented to EMS with extreme pallor, Levine sign, diaphoresis, bilateral arm pain, and an apprehensive sense of doom. Past medical history included HTN, HLD, and MI 10 years prior. It should be emphasized here that this is a presentation of high-pretest probability fo

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review by Dr. Stephen Smith @smithECGblog I was reviewing ECG’s in our LifeNet database and happened upon this one without any knowledge of clinical circumstances. Figure 1 Raw findings include Sinus Rhythm, narrow QRS duration, small q-waves in Leads I / aVL / V5 / V6 (which is not entirely atypical), an inverted P-wave in V1 to suggest possible lead malposition, a normal QRS/T angle, and a d

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Expert commentary provided by Dr. Ken Grauer CASE 1 An 82 y/o Male called 911 for sudden onset dizziness while at rest. Upon arrival he was found alert and oriented, and without gross distress. He denied difficulty breathing, epigastric pain, or chest discomfort. BP 110/67 HR 68 RR 14 (non-labored) SpO2 95 RA Physical exam revealed slight pallor and diaphoresis. Auscultation of breath sounds did no