The Trouble with Sinus Tachycardia
Sometimes recognizing sinus tachycardia can give us fits.
What? Sinus tachycardia? One of the most basic rhythms?
The discussion that follows will highlight some of the difficulties sinus tach can present at high rates. The pitfalls of using the generalized term "SVT" will also be discussed. This discussion is not meant to imply that this issue is easy to navigate. It can get very difficult, and very dicey. The consequences of misinterpreting the rhythm and missing sinus tach can have very deleterious effects for our patients.
We are all good at recognizing sinus tachycardia at rates between 100-150, but w...
Source: EMS 12-Lead - April 30, 2013 Category: Cardiology Authors: David Baumrind Tags: ems-health-safety ems-topics patient-management Training training-development 12-Lead ECG ACLS David Baumrind ems12lead.com narrow complex tachyardias sinus tachycardia SVT treating SVT with adenosine Source Type: research
Episode #11 – Are we harming patients with oxygen?
EMS 12-Lead podcast – Episode #11 – Are we harming patients with oxygen?
In this episode of the EMS 12-Lead podcast we're joined by Kelly Arashin, ACNP, CCNS and Mike McEvoy, PhD, RN, CCRN, REMT-P at EMS Today 2013 in Washington D.C. We discuss the benefits and dangers of oxygen administration.
Kelly is a dual boarded advanced practice nurse and Chair of the Hypothermia Steering Committee at Hilton Head Hospital in Hilton Head Island, SC.
Mike describes himself as a nurse, paramedic, firefighter, and medical college professor. He is also Chair of the Resuscitation Committee for University Teaching Ho...
Source: EMS 12-Lead - March 27, 2013 Category: Cardiology Authors: Tom BouthilletEMS 12-Lead Tags: ems-topics patient-management are we harming patients with oxygen can oxygen hurt EMS12Lead podcast Kelly Arashin Mike McEvoy oxygen administration Tom Bouthillet Source Type: research
Code STEMI – London Ambulance Service
Ivan Rokos, M.D. has referred to primary PCI for acute STEMI as “the most complex, multi-disciplinary, and time-sensitive therapeutic intervention in the world of medicine.”
The emphasis on door-to-balloon times, and more recently, first medical contact or EMS-to-balloon times has transformed how acutely ill patients suffering heart attacks receive timely reperfusion in many communities, because as we’re so often told, “time is muscle.”
While some believe that the emphasis on door-to-balloon times has unintended consequences, in our opinion the real-life stories of the men and women who build ...
Source: EMS 12-Lead - March 18, 2013 Category: Cardiology Authors: Tom Bouthillet Tags: Dispatch & Communications EMS Dispatch ems-topics patient-management Uncategorized Code STEMI Web Series EMS in the UK London Ambulance Service Source Type: research
Code STEMI Web Series – London to premier at EMS Today in Washington, D.C.
Seaon 2 of the Code STEMI Web Series is set to launch on March 7, 2013 at EMS Today in Washington, D.C.! This season starts out with our most exciting location ever — London, England as we feature the London Ambulance Service (LAS).
You can follow the series at First Responders Network or at CodeSTEMI.tv.
Special thanks to Physio-Control for sponsoring this web series!
Speaking of which, you can download the schedule for Physio-Control University at EMS Today by clicking here (PDF).
I'll be teaching an educational session called Hilton Head Island – Strengthening a Community's Chain-of-Survival. I...
Source: EMS 12-Lead - February 24, 2013 Category: Cardiology Authors: Tom Bouthillet Tags: ems-topics patient-management videos Code STEMI Web Series Hilton Head Island London Ambulance Service Physio-Control Source Type: research
47 year old male: Holiday Indigestion – Conclusion
This is the conclusion to 47 year old male: Holiday Indigestion. Thanks go to a long time reader Nicholas Eisele for this holiday case! Editor's Note: sorry for the delay, it helps to press "publish"!
When we left off, our patient was in the back of the truck with a burning sensation radiating to his back. We had run a 12-Lead ECG and our partner was wondering which facility you wanted him to drive to.
To answer that question, we should look at the 12-lead!
This 12-Lead shows a normal sinus rhythm at 70 bpm without ectopy or bundle branch block. A case could be made for incomplete right bundle branch block g...
Source: EMS 12-Lead - February 19, 2013 Category: Cardiology Authors: Christopher Watford Tags: ems-topics patient-management 12-Lead ECG acute inferior STEMI cardiac cath lab activation Christopher Watford data quality E2B EMS 12-Lead Localized ST-depression Paramedic Source Type: research
47 year old male: Holiday Indigestion
Thanks go to a long time reader Nicholas Eisele for this holiday case! As always, details have been changed to protect patient privacy.
It is a blustery Christmas morning when you and your partner are dispatched for a 47 year old male with chest pain. Firefighters are already on scene obtaining a history and vitals when you arrive.
You check in with the officer in charge, a paramedic, and he reports that the patient has been having a "burning sensation" in the middle of his chest, going to his back. As it is Christmas morning and the patient's family is opening presents, the officer also relays the patient, &...
Source: EMS 12-Lead - January 24, 2013 Category: Cardiology Authors: Christopher Watford Tags: ems-topics patient-management 12-Lead ECG case study Christopher Watford data quality EMS 12-Lead Paramedic Source Type: research
New Infographic: Left Anterior Fascicular Block (LAFB)
Since infographics are all the rage nowadays I thought we'd put some together for ECG interpretation.
I'm starting with left anterior fascicular block… well, just because!
I hope you find these to be useful!
See also: Left anterior fascicular block (Source: EMS 12-Lead)
Source: EMS 12-Lead - January 23, 2013 Category: Cardiology Authors: Tom Bouthillet Tags: ems-topics patient-management left anterior fascicular block Source Type: research
“What’s wrong with Mr. Wilson?”
It is a sunny January afternoon at the ER when you are called to see a 57 year old male complaining of feeling "really sick".
You find your patient lying in the bed in room 3. He looks pale and short of breath. You introduce yourself and ask him why he has come in today.
He says:
"About two weeks ago, I started feeling short of breath, with a cough. I got much more tired than usual. I went to see my doctor, who said I had an upper respiratory infection and prescribed me some antibiotics. I rested at home for a few days, and started to feel a little better. Then, I began to go downhill again. Felt so a...
Source: EMS 12-Lead - January 19, 2013 Category: Cardiology Authors: David Baumrind Tags: ems-health-safety ems-topics patient-management Training training-development 12-Lead ECG case study David Baumrind ems12lead.com Paramedic respiratory distress Source Type: research
HyperK and Shades of Grey: Myths and Facts about Hyperkalemia Part II
Today we continue our discussion about the myths and facts of hyperkalemia with Dr. Brooks Walsh, author of the Mill Hill Ave Command blog. We also feature contributions from Dr. Stephen Smith, of Dr. Smith's ECG Blog.
If you would like to refresh your memory on Part I visit here.
Dr. Walsh and I spoke about why he thought hyperkalemia presented such a challenge for EMS providers:
"The recognition and treatment of hyperkalemia is one of those areas in medicine wher...
Source: EMS 12-Lead - January 14, 2013 Category: Cardiology Authors: David Baumrind Tags: ems-health-safety ems-topics patient-management Training training-development 12-Lead ECG Brooks Walsh M.D. David Baumrind ems12lead.com hyperkalemia Myths Paramedic Stephen Smith M.D. Source Type: research
HyperK and Shades of Grey: Myths and Facts about Hyperkalemia Part I
Happy New Year everybody!
We start 2013 with a continuation of our discussion about the field treatment of hyperkalemia.
It might be helpful to review the first part of the discussion," HyperK and Shades of Grey" here.
We are fortunate to have as a guest contributor Dr. Brooks Walsh of the Mill Hill Ave Command blog. An advocate of prehospital medicine, Dr. Walsh offers shares "Myths and Facts" of hyperkalemia with us. My sincerest thanks him for his valued contributions!
I asked Dr. Walsh why he thought hyperkalemia presented such a challenge for EMS providers. Here is what he h...
Source: EMS 12-Lead - January 1, 2013 Category: Cardiology Authors: David Baumrind Tags: ems-health-safety ems-topics patient-management Training training-development 12-Lead ECG Brooks Walsh M.D. David Baumrind EMS myths ems12lead.com hyperkalemia Paramedic Source Type: research
