EMS 12-Lead

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review and commentary by Dr. Steve Smith http://hqmeded-ecg.blogspot.com/ @SmithECGblog It is early-summer, approximately 1330 hours, no cloud cover overhead, and 86 degrees with high humidity. A 59 y/o Female calls 911 for crushing chest discomfort and difficulty breathing. Fire/EMS personnel find her laying supine on the kitchen floor, awake and verbal, although acutely ill. She reports havi

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review provided by Dr. Steve Smith http://hqmeded-ecg.blogspot.com/ @SmithECGBlog An adult female called 911 for chest discomfort and difficulty breathing. EMS found her acutely ill, mottled, dry mucous membranes, modestly hypotensive, and lethargic. She reported a history of IDDM, but denied any known ischemic heart disease. A finger-stick glucose resulted 551 mg/dL, and the following ECG was