You respond to a 72 y/o female complaining of shortness of breath. Upon arrival you find an average sized elderly female with tachypnea and pale, moist skin. She states that she can’t do anything without feeling very short of breath. This is the ECG you obtain on the patient, what are you thinking at this point?
Watch the video below for the full case review and interpretation.
You respond to a 65 y/o Male at his residence. His daughter, on scene, called 911 because she is worried about her father’s health. She states that he just hasn’t been acting right. “He is weaker than normal, and becomes short of breath very easily”. The patient himself is not thrilled about your presence. He is a rather obese man (about 400 lbs), and he is sitting in his recliner sans shirt or pants. His immediate area provides evidence that he doesn’t move
S – The patient states that he is always weak and it is normal for him to get short of breath when he gets up.
A – NKDA
M – Glucophage, Gabapentin, Albuterol, Singulair, Prevacid, Carevedilol, Enalapril, Digoxin, Aspirin, Oxygen
P – AMI, CHF, Asthma, Non-insulin dependent diabetes, AICD
L – Oreos and Orange Juice
E – Sitting in his chair
B/P: 61/37, Left Arm
SpO2: 83, on 2 lpm O2,
Pulse: 40 & regular
Resp: 30 & regular
Skin: Pale, cool, & clammy
You place your patient on the monitor and obtain the following 12-lead. What would you immediately ask your patient? What is your interpretation of the ECG? What treatments would you provide?
You respond to a 70 y/o male with chest pain and shortness of breath. He has no other complaints and states that this began while working in the garage.
S – Chest pain & dyspnea
A – Aspirin and codeine
M – Coreg, Novolog, Gabapentin, Ni
P – CHF, CABG, Insulin dependent diabetes, HTN
L – Budweiser while working in garage
E – Working on lawn mower in garageO – Began suddenly
P – Exertion worsens pain
Q – Pressure
R – Non-radiating
S – 3/10
T – Began about 30 min. ago
You obtain a 12-lead ECG. What is your impression of this ECG?
I’ve been at it again with the video tutorials. Here is a quick, two-part explanation of Bundle Branch Blocks. I explain what causes the ECG changes associated with bundle branch blocks to the best of my abilities within the short amount of time that Youtube allows.
Did you know that both types of bundle branch blocks require you to look at more than just lead V1 to truly identify them? If not, make sure you see part 2.
You respond to a community college for a 22 y/o male who was having chest palpitations. Bystanders on scene state that the patient “looked like he was going to pass out”. As you arrive, you find a seemingly healthy male, sitting upright in no distress. He states that this happens all the time, and he doesn’t want to go to the hospital. He feels fine now.
A – NKDA
M – No meds
P – No known medical history
L – Red Bull and a muffin before class
E – Walking to classroomVitals:
HR: 75 & regular
RR: 22 & regular
Skin: Pink, warm, & dry now but bystanders state that he was pale and clammy when they called 911.You obtain the attached ECG on the patient. What is your interpretation? Should you encourage him to go to the hospital? Does this explain his symptoms?
Watch video below for full case review.