Conclusion: 87yom complaining of chest discomfort and dyspnea
Conclusion:
It was concluded that cardiac biomarkers were elevated secondary to Acute Renal Failure, which resulted in Acute Heart Failure. (Source: EMS 12-Lead)
Source: EMS 12-Lead - February 1, 2014 Category: Cardiology Authors: Ivan Rios Tags: 12 lead ecg CHF Heart Failure LBBB Uncategorized Dr. Smith's Modified Sgarbossa Rule IVAN RIOS Source Type: research
87 yom complaining of chest discomfort and dyspnea
On a Thurday morning, approximately 02:15 hrs, in a small rural town, your EMS unit is dispatched to a residence for an 87 year old male with difficutly breathing.
You arrive on scene before the fire engine and enter the residence. Upon entering the bedroom, you find an elderly male, sitting on the edge of the bed, vomiting. He is alert and oriented x 4 (person, place, time, event) and with a GCS of 15. He appears to be in moderate respiratory distress, diaphoretic, with rapid and slightly labored breathing and muscle retraction, but yet, he's smiling at you and tries to...
Source: EMS 12-Lead - January 28, 2014 Category: Cardiology Authors: Ivan Rios Tags: 12 lead ecg CHF LBBB 12-Lead ECG chest discomfort dyspnea IVAN RIOS sgarbossa's criteria STEMI Source Type: research
87 yom complaining of chest discomfort and dyspnea
On a Thurday morning, approximately 02:15 hrs, in a small rural town, your EMS unit is dispatched to a residence for an 87 year old male with difficutly breathing.
You arrive on scene before the fire engine and enter the residence. Upon entering the bedroom, you find an elderly male, sitting on the edge of the bed, vomiting. He is alert and oriented x 4 (person, place, time, event) and with a GCS of 15. He appears to be in moderate respiratory distress, diaphoretic, with rapid and slightly labored breathing and muscle retraction, but yet, he's smiling at you and tries to ...
Source: EMS 12-Lead - January 28, 2014 Category: Cardiology Authors: Ivan Rios Tags: 12 lead ecg CHF LBBB 12-Lead ECG chest discomfort dyspnea IVAN RIOS sgarbossa\'s criteria STEMI Source Type: research
Snapshot Case: 45 Year Old Female–Chest Pain
Here is the latest from our "Snapshot" case collection..
This ECG was taken from a 45 year old female patient who had "off and on" chest pain for about 24 hours. The discomfort radiated to her left arm, and she complained of some "dizziness". She denies any associated SOB, or N/V. The discomfort worsened over the last few hours without relief, so she presented to her PCP.
Her past history is significant for hypertension and uterine cancer, and smoking 1 pack/day.
HR: 74 regular
BP: 148/86
RR: 16 regular, sp02 98% RA
Skin: warm and dry
She had received 324 o...
Source: EMS 12-Lead - January 20, 2014 Category: Cardiology Authors: David Baumrind Tags: ems-health-safety ems-topics patient-management Training 12-Lead ECG David Baumrind ems12lead.com Paramedic Prehospital 12-Lead ECG blog Source Type: research
Pulmonary pressures and ecg patterns
Conclusion:
Obtaining a 12 lead ECG is an important aspect of our pre-hospital and in-hospital setting evaluation of both cardiac and respiratory patients, as increased pulmonary pressure changes can dramatically alter cardiac function with or without prior cardiac history. (Source: EMS 12-Lead)
Source: EMS 12-Lead - January 16, 2014 Category: Cardiology Authors: Ivan Rios Tags: Atrial Fibrillation COPD mat 12-Lead ECG multifocal atrial tachycardia Pulmonary Hypertension RBBB RVH Source Type: research
Pulmonary pressures and ecg patterns
Conclusion:
Obtaining a 12 lead ECG is an important aspect of our pre-hospital and in-hospital setting evaluation of both cardiac and respiratory patients, as increased pulmonary pressure changes can dramatically alter cardiac function with or without prior cardiac history. (Source: EMS 12-Lead)
Source: EMS 12-Lead - January 16, 2014 Category: Cardiology Authors: Ivan Rios Tags: Atrial Fibrillation COPD mat 12-Lead ECG multifocal atrial tachycardia Pulmonary Hypertension RBBB RVH Source Type: research
63 Year Old Female, CC: Neck and Arm Pain–Discussion
This is the discussion for our recent case 63 Year Old Female, CC: Neck and Arm Pain.
Let's revisit the 12 Lead ECG:
There "appears" to be a Sinus Brady rhythm at a rate of about 52 bpm, with a first degree AVB. The rhythm is regular for the first half of the ECG, then there appears to be a couple of PACs or PJCs in the second half. The axis is normal. There is ST elevation in leads II, III, and aVF and V6, with ST depression in I, aVL, V1 and V2.
As many of you correctly presumed, our patient was having an inferior STEMI, probably extending to the posterior and lateral walls. Was the...
Source: EMS 12-Lead - January 14, 2014 Category: Cardiology Authors: David Baumrind Tags: ems-topics fire-rescue-topics patient-management Training training-development 12-Lead ECG bradycardia case study David Baumrind ems12lead.com first degree AVB inferior STEMI Paramedic Prehospital 12-Lead ECG blog second degree Source Type: research
63 Year Old Female, CC: Neck and Arm Pain–Discussion
This is the discussion for our recent case 63 Year Old Female, CC: Neck and Arm Pain.
Let's revisit the 12 Lead ECG:
There "appears" to be a Sinus Brady rhythm at a rate of about 52 bpm, with a first degree AVB. The rhythm is regular for the first half of the ECG, then there appears to be a couple of PACs or PJCs in the second half. The axis is normal. There is ST elevation in leads II, III, and aVF and V6, with ST depression in I, aVL, V1 and V2.
As many of you correctly presumed, our patient was having an inferior STEMI, probably extending to the posterior and lateral walls. Was the ...
Source: EMS 12-Lead - January 14, 2014 Category: Cardiology Authors: David Baumrind Tags: ems-topics fire-rescue-topics patient-management Training training-development 12-Lead ECG bradycardia case study David Baumrind ems12lead.com first degree AVB inferior STEMI Paramedic Prehospital 12-Lead ECG blog second degree Source Type: research
Understanding Digoxin
Most of us have heard of, or encountered a patient taking Digoxin at some point in our carreers. But, do we understand what it is and how it affects our patient?
Digoxin (Lanoxin), is a Cardiac Glycoside, derived from the foxglove plant, Digitalis. This medication is often seen in the pre-hospital setting, used for the treatment of:
Heart Failure (HF) with reduced Systolic Function
Atrial Fibrillation (AF) and Atrial Flutter (A-flutter) associated with Rapid Ventricular Response (RVR)
Cardiomyopathies
Often combined with Calcium and Beta Channel Blockers, Angiot...
Source: EMS 12-Lead - January 10, 2014 Category: Cardiology Authors: Ivan Rios Tags: Atrial Fibrillation Bidirectional Ventricular Tachycardia Digoxin Digoxin toxicity Heart Failure Source Type: research
68 Year Old Male: Chest Tightness – Part 2
This is part 2 of a multi-part series examining a 68-year-old male patient who presented with a chief complaint of "chest tightness" and an abnormal ECG. You may want to review the initial description of the patient here. We're going to save the dissection of the ECG's for the next post and continue on with his case presentation for now…
You start by administering 324mg of aspirin PO, chewed well. Recognizing that the patient is in rapid atrial fibrillation at about 127 bpm and that his elevated heart-rate could be contributing to his symptoms, you start to draw up a loading-dose of diltiazem to ...
Source: EMS 12-Lead - December 31, 2013 Category: Cardiology Authors: Vince DiGiulio Tags: ems-health-safety ems-topics patient-management Training training-development 12-Lead ECG case study EMS 12-Lead ems12lead.com posterior leads ST-depression ST-elevation in lead aVR Vince DiGiulio Source Type: research
68 Year Old Male: Chest Tightness – Part 2
This is part 2 of a multi-part series examining a 68-year-old male patient who presented with a chief complaint of "chest tightness" and an abnormal ECG. You may want to review the initial description of the patient here. We're going to save the dissection of the ECG's for the next post and continue on with his case presentation for now…
You start by administering 324mg of aspirin PO, chewed well. Recognizing that the patient is in rapid atrial fibrillation at about 127 bpm and that his elevated heart-rate could be contributing to his symptoms, you start to draw up a loading-dose of diltiazem to sl...
Source: EMS 12-Lead - December 31, 2013 Category: Cardiology Authors: Vince DiGiulio Tags: ems-health-safety ems-topics patient-management Training training-development 12-Lead ECG case study EMS 12-Lead ems12lead.com posterior leads ST-depression ST-elevation in lead aVR Vince DiGiulio Source Type: research
68 Year Old Male: Chest Tightness – Part 1
A 68-year-old male presents with a chief complaint of chest tightness that started at rest approximately three hours prior and has been constant ever since. He desribes it as a vice-like sensation limited to the central portion of his chest. Nothing makes the pain better or worse and he rates it at about a 6 out of 10.
At a glance the patient appears pretty healthy. He is well-nourished and of normal weight, does not smoke, and feels alright aside from the nagging discomfort in his chest. His skin in warm, pink, and dry and his radial pulse is strong, fast, and irregular.
Vitals are as follows:
HR approx 125 bpm, ir...
Source: EMS 12-Lead - December 30, 2013 Category: Cardiology Authors: Vince DiGiulio Tags: ems-health-safety ems-topics patient-management Training training-development 12-Lead ECG atrial fibrillation case study EMS 12-Lead ems12lead.com ST-depression ST-elevation in lead aVR Vince DiGiulio Source Type: research
