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Great topic! It's a good area to review, and paramedics should know this stuff cold. That said, there's a lot of misinformation, myth, or outdated stuff out there. I've reviewed this topic a few times in "Anaphylaxis Knowledge Among Paramedics", " New Guidelines for Anaphylaxis ", and "...

If you already know something about ECGs, you might be better off with a fat book of practice 12-leads instead of another textbook. A pretty good one, for example is Mattu's ECGs for the Emergency Physician. Another one is 150 Practice ECGs, which I first tackled in medic school. Just...

Heh. "Tienes." I had started off using solely the formal conjugation when addressing patients, so that I could show some respect and gain trust, even if my vocab or pronunciation was ugly. As a result, though, children just laugh at me when I ask them "¿Donde le duele, usted?" They just...

True dat. For a discussion of a few ways of being fooled by the STEMI-imposters, you might want to check out a review at An Alternative Method of ECG Interpretation. After that, you have to hit the examples at EMS 12-lead and Dr. Smith's ECG Blog - plenty of great examples and discussions at...

Your experience serves you well. The only time we use a backboard in the ED is to get a patient off the floor. It's worth it to point out that ATLS (the standard trauma course for docs) teaches that the backboard is only utilized for transport to the ED. Everyone comes off the board in the ED...

There is a lot of "benign" ST elevation out there. Early repolarization, as Brandon noted, is very common in young males. The "slurred" J-points in V4, V5 suggest this. But by my eye, and the computerized J-point calculations, the elevations are most pronounced in V2 & V3, where the complexes...

Brendan - This is also a great opportunity for you! The fact is that a lot of people who are trying to learn a foreign language have trouble finding ways they can practice their skills, and would be envious of your situation. And the medical environment is great for the beginner. I say...

I'm with Christopher on this one. A 91 y.o. who fell in the ECF is not exactly a good risk for the cath lab. She could bleed into her head, they could easily laceration her (probably diagonal!) coronary artery, or god knows what. For what it's worth, the ECG looks legit, and I'm guessing...

No, perhaps we're just not responding in the spirit you aimed for! Sorry about that - I'll get back on track here. Indeed, the American system encourages EMS providers to focus on a primary, provisional diagnosis. However, some (many?) critics would suggest that this aspect is overemphasized...

I just want to highlight a point about cricoid pressure (i.e Sellick's) that is misunderstood by many people, including some physicians. It boils down to this: Cricoid pressure ≠ BURP ≠ External laryngeal manipulation I go in a bit more detail in my review Intubation and Mis-en-place, but let...

Indeed - some would suggest that "patients can have as many diseases as they damn well please!"

One small point about your description of the ECG - if you just have a rhythm strip, you can't really interpret the ST-segments. This women sounds more like CHF, given the respiratory complaint, and the cardiac findings, as well as the hypoxia. However, the RR of 36, with no apparent...