Search results

My parents recently moved back into my EMS system's jurisdiction and my father just turned 83. If he contacted 9-1-1 at 0330 Sunday morning with an ECG like this (especially depending who was on call) I would just assume they treat him medically and re-assess. Make no mistake, if they were...

It may be bad news but I don't agree that it should be an automatic prehospital cath lab activation unless there is consensus on this point with Emergency Medicine and Cardiology. Steve Smith, M.D. writes about this frequently and specifically mentions the Yamaji study...

I just took a page out of Steve Smith's playbook and started calling anterior STEMI "LAD occlusion" which avoids the problem of having to say absurd things like "anteroseptal STEMI with lateral extension". ST-elevation in aVR with widespread ST-depression is rarely due to left main coronary...

Same thing! :)

"The comments on most of the posts are useless. Everyone seems to think of something completely different." This can be frustrating for people. It was true when I worked as a cardiac monitoring technician in a critical care stepdown unit. "Ask 3 different cardiologists...." Then I realized that...

This reminds me of Rhythm Challenge #5. Part 1 http://www.ems12lead.com/2010/11/26/rhythm-challenge-5/ Part 2 http://www.ems12lead.com/2010/11/27/rhythm-challenge-5-answer/ In the bottom strips the pacemaker keeps firing but finds the ventricles refractory due to the native rhythm (sometimes...

Looks like AF with runs of VT to me.

The relatively young age and extreme rate suggest WPW Syndrome. Could be a reciprocating tachycardia or 1:1 flutter. You could apply the defibrillator pads and attempt adenosine which would either break the rhythm or confirm 1:1 flutter. Or, if hemodynamically unstable, sedate and perform...

A new post on a STEMI equivalent: de Winter ST/T-waves! http://www.ecgmedicaltraining.com/de-winter-stt-waves/ Tom

EMT Lifers: I wrote a new 2-part blog post on WPW Syndrome. Part 1: http://www.ecgmedicaltraining.com/wolff-parkinson-white-wpw-syndrome-part-1/ Part 2: http://www.ecgmedicaltraining.com/wolff-parkinson-white-syndrome-part-2/ Tom B.

Robb: The ECG shows clear-cut VT. The desire to call a wide complex tachycardia SVT with aberrancy is very powerful. I'm not entirely sure why but it's true! One of my missions in life is to counteract this desire in the minds of emergency clinicians. Here are some things to keep in mind...

The habits you develop right now will last your entire career (good or bad). Lay out your equipment and spike your IV bag using the proper aseptic technique. Shut down the roller clamp prior to squeezing the drip chamber. It helps prevent air bubbles in the IV line. There is no need to remove...

"I'm great at math. I'm terrible at math during a code." - Peter Antevy, M.D.

Here's a solution I've been working on that includes age and length-based color. https://www.facebook.com/ems12lead/photos/pb.216914116048.-2207520000.1433511931./10153169906726049/ Tom

If the only abnormality on this ECG was the abnormality present in leads V1-V3 I would call it acute isolated posterior STEMI. It is true that you can "train your mind" to see acute isolated posterior STEMI by paying close attention to these leads in the setting of acute inferior STEMI because...

I just finished a 3-part series on chest pain and left bundle branch block. Part 1: http://www.ecgmedicaltraining.com/making-sense-of-sgarbossas-criteria-chest-pain-and-left-bundle-branch-block-part-1/ Part 2...

Does anyone know if rhan101277 is still around? The AACN is doing an online class about TCP and I was wondering if they could obtain permission to use these ECGs as examples of false capture. Thanks, Tom B.

Most pediatric drugs (not all) are dosed according to lean body mass which is why length based and age based estimations are acceptable (and comparable). Dr. Broselow says it's acceptable to "bump up a color" if the child is large for his/her age. But, considering that so many kids are not...

I met Peter Antevy, M.D. and his wife Allison at EMS Today 2015 where he received an EMS 10 Award. He's a great guy. I also attended two of his classes. I wrote about it here...

If you're going to bother taking a DNR patient to the cath lab (one imagines after consent from the patient or family) then it makes sense to defibrillate if the patient experiences VF during the procedure. It's a common thing that happens especially when reperfusing the RCA. That's a different...