Remove Circulation Remove Dysrhythmia Remove Ultrasound
article thumbnail

Severe shock, obtunded, and a diagnostic prehospital ECG. Also: How did this happen?

Dr. Smith's ECG Blog

On arrival, the patient was in shock, was intubated, and had an immediate cardiac ultrasound. What does a heart look like on ultrasound when the EKG looks like that? Here you go: It's not the world's greatest cardiac ultrasound video, but it does appear to show poor function and low volume. They transported to the ED.

article thumbnail

Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.

article thumbnail

STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes

Dr. Smith's ECG Blog

Bedside ultrasound showed no effusion and moderately decreased LV function, with B-lines of pulmonary edema. Could the dysrhythmias have been prevented? mEq of K pushed fast and circulated theoretically would raise serum K immediately by 1.0 He was managed medically with Clopidogrel. He appeared to be in shock. mEq/L, from 1.9

STEMI 52
article thumbnail

New Onset Heart Failure and Frequent Prolonged SVT. What is it? Management?

Dr. Smith's ECG Blog

A bedside POC cardiac ultrasound was done: Findings: Decreased left ventricular systolic function. Because the AP lies outside of the AV node — the time to circulate around the reentry pathway and conduct back to the atria ( retrograde ) is longer than when the entire reentry circuit is contained within the AV node.

article thumbnail

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Circulation. Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. orthostatic vitals b. 2004;110:3636-3645.