Remove Dysrhythmia Remove Hemorrhage Remove Outcomes
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A teenager involved in a motor vehicle collision with abnormal ECG

Dr. Smith's ECG Blog

Massive Transfusion for Motorcycle Collision with Hemorrhage, Troponin Elevated. Atrial fibrillation is also a predictor of worse outcomes in this case (Alborzi). Between 81-95% of life-threatening ventricular dysrhythmias and acute cardiac failure occur within 24-48 hours of hospitalization.

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A Child with Blunt Trauma

Dr. Smith's ECG Blog

Blunt cardiac injury my result in : 1) Acute myocardial rupture with tamponade 2) Valve rupture (tricuspid, aortic, mitral) 3) Coronary thrombosis or dissection (and thus Acute MI) from direct coronary blunt injury 4) Dysrhythmias of all kinds. If it had been, could this outcome have been anticipated? And, then, so what?

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A 50 year old man with sudden altered mental status and inferior STE. Would you give lytics? Yes, but not because of the ECG!

Dr. Smith's ECG Blog

Side note: The differential of sudden persistent loss of consciousness with adequate hemodynamics is relatively short: seizure, intracranial hemorrhage, basilar artery occlusion. There was again no intracranial hemorrhage. Long-term outcome is unknown. Serial troponins were negative.

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

Dr. Smith's ECG Blog

Also consider non-hemorrhagic volume depletion, dehydration : orthostatic vitals may uncover this [see Mendu et al. (3)]. Cardiac Syncope ("True Syncope") Independent Predictors of Adverse Outcomes condensed from multiple studies 1. These premonitory symptoms were negative predictors of adverse outcomes in EGSYS.