Computer misses it, but the medic catches it.

True fact: I failed out/dropped out of grad school in mathematics. But despite having little enthusiasm for topology or complex analysis, nothing drives me more nuts than people who say stuff like “I’m not good at math – just not a math person, I guess.” This attitude is not just incorrect, it’s harmful. Most mathematics is quite straight-forward, if you practice and study conscientiously. Same with ECGs. Stratford EMS was called for a (quite) elderly woman who wasn’t feeling well. And of course, she lived on the 5th floor of a building with narrow, twisting stairs. Nonetheless, the paramedic Jay and his crew humped all their gear, including the Like-Pak, up those stairs. Good thing too. There was a small language barrier, but Jay ascertained that the woman was complaining of a “burning” in her epigastrium that she also felt in her back. This had started within the last hour. VS were normal, as was the exam, except that she “didn’t look right.” Time for the 12-lead! Does it meet STEMI criteria? There’s a bunch of ST segment depression in the inferior and lateral leads, but (as you all know) that doesn’t usually count for field activation. There is ST segment in aVL, but it is < 1mm, and aVR shows only minor STE, while lead I shows none. V2 and V3 show some STE, but it isn’t much, and it would have been easy for Jay to tell himself that, since the computer didn’t “see” it, it wasn’t really there. Instead, he turned his attention to V4…...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: Uncategorized Source Type: research