Remove Cardiac Arrest Remove Dysrhythmia Remove STEMI
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Severe shock, obtunded, and a diagnostic prehospital ECG. Also: How did this happen?

Dr. Smith's ECG Blog

If cardiac arrest from hypokalemia is imminent (i.e., to greatly decrease risk (although in STEMI, the optimal level is about 4.0-4.5 As I indicated above, in our cardiac arrest case, after pushing 40 mEq, the K only went up to 4.2 Give an initial infusion of 10 mEq IV over 5 minutes; repeat once if needed.

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A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

He had multiple cardiac arrests with ROSC regained each time. Then there is loss of pulses with continued narrow complex on the monitor ("PEA arrest") Learning Points: Sudden witnessed Cardiac Arrest due to ACS is almost always due to dysrhythmia. This patient arrested shortly after hospital arrival.

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A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

A prior ECG from 1 month ago was available: The presentation ECG was interpreted as STEMI and the patient was transferred emergently to the nearest PCI center. There were no dysrhythmias on cardiac monitor during observation. So maybe she is better than I am. He was found to be influenza positive. Is there fever again?

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Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

2) The STE in V1 and V2 has an R'-wave and downsloping ST segments, very atypical for STEMI. Cardiology was consulted and they agreed that the EKG had an atypical morphology for STEMI and did not activate the cath lab. Smith comment: 1) Brugada ECG may have ST shifts in limb leads as well as precordial leads. Bicarb 20, Lactate 4.2,