EKG Practice #3

Ray Fowler, MD is Professor of EM / EMS at UTSW / Parkland. Edited by Alex Koyfman, MD.

Case #1

This 77 female presents with chest discomfort of several hours duration. She has a hx of stable angina, and she has not had any coronary intervention. On this evening, her discomfort worsened, and she called 911 and EMS responded.

En route you are contacted through BioTel that they would like for you to come and look at the transmitted ECG. They are worried that the patient may need cardioversion (see V1) or to at least go onto an antiarrhythmic drip. The following 12-lead is handed to you as you walk into the radio room. Look at V1. You have to make a decision NOW. Make your decision as to what to do.


Case #2

An 80 year-old male presents in acute distress with the worsening of chest tightness over the last few hours of the afternoon. He has had this before, he has stable angina, he has had a previous stent placed in the LAD, and he is compliant with his daily Plavix use. The ED is packed, the triage nurse has brought him back in a wheelchair, and he speaks only Burmese. What would you do?


What’s New: A Review of the Sepsis Literature

There have been a number of new publications reviewing our approach to managing sepsis. Both the ProCESS Trial and ARISE trial published in 2014 editions of the New England Journal question whether invasive procedures and rigid protocols are required to have positive patient outcomes. Other studies included in this power review examine the importance of early antibiotic therapy, effects of different mean arterial pressure parameters, and impact of chloride heavy versus chloride restricted solutions.

Ask Me Anything With Mike Stone, MD (@bedsidesono)

We’ll give details on the new date/time for this AMA soon. Apologies for any inconvenience!

We’re very pleased to announce that our next Ask Me Anything will be with Mike Stone, MD, RDMS. Dr. Stone is the Division Chief of Emergency Ultrasound and the Emergency Ultrasound Fellowship Director at Brigham and Women’s Hospital in Boston, MA, and can be found on Twitter as @bedsidesono.

Emergency Medicine Education