Ischemia Nursing Stents 
Dr. Smith's ECG Blog
MARCH 27, 2025
But it was interpreted as no acute ischemia and the patient was referred to cardiology as Non-STEMI. The total occlusion was recanalized and stented from 100 to 0%. Clinical: patient alerts for refractory ischemia (refractory chest pain), and empowering nurses to advocate for patients 4.
EMS 12-Lead
MAY 20, 2022
David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review and commentary by Dr. Steve Smith [link] @SmithECGblog It is early-summer, approximately 1330 hours, no cloud cover overhead, and 86 degrees with high humidity. There is LBBB-like morphology with persistent patterns of subendocardial ischemia.
Dr. Smith's ECG Blog
OCTOBER 26, 2011
In spite of aggressive questioning, he denied chest pain, but he did tell one triage nurse that he had had some chest burning, and so he underwent an ECG: There are deep Q-waves and QS-waves in precordial leads V2-V3, with a bit of R-wave left in V4. An open 90% LAD was stented. He had been awakened by cough at 3 AM 2 days earlier.
EMS 12-Lead
JUNE 20, 2022
David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review provided by Dr. Steve Smith @SmithECGblog I was conducting QA/QI on two very recent cases and was struck by the uniqueness of both. He was rushed to the Cath Lab where an LAD culprit lesion was stented. Here is the LAD after stent placement.
EMS 12-Lead
APRIL 2, 2022
David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Expert commentary provided by Dr. Ken Grauer CASE 1 An 82 y/o Male called 911 for sudden onset dizziness while at rest. A 99% LAD occlusion was stented. Upon arrival he was found alert and oriented, and without gross distress. Attached is the first ECG.
Dr. Smith's ECG Blog
OCTOBER 8, 2023
Triage is backed up, and 10 minutes into your shift one of the ED nurses brings your several ECG s that has not been overread by a physician. The patient was referred immediately for cath which revealed RCA occlusion that was stented. There are well formed R-waves with good voltage/amplitude which is uncommon for ischemia.
Dr. Smith's ECG Blog
AUGUST 10, 2023
The nurse alerted the MD because the patient was still symptomatic, diaphoretic and “looking unwell”. Even though they were passed the 12 hour mark traditionally associated with reperfusion benefits, ongoing ischemia requires emergent angiogram On assessment, the patient appeared uncomfortable, leaning forward in his chair. Shroff, G.
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