Paramedicine 101

ECG Case 9

Adam Thompson, EMT-P — Sat, 15 Dec 2012 19:41:28 +0000

ECG Case 8

Adam Thompson, EMT-P — Sat, 01 Dec 2012 14:30:29 +0000

ECG Case 7

Adam Thompson, EMT-P — Wed, 14 Nov 2012 23:44:14 +0000

ECG Case 6

Adam Thompson, EMT-P — Tue, 06 Nov 2012 23:58:38 +0000

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?

ECG 6 – Click to enlarge

Watch the video below for the full case review and interpretation.

Click here to view the video on YouTube.

ECG Case 5

Adam Thompson, EMT-P — Mon, 05 Nov 2012 15:42:05 +0000

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

from that chair very often.

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?

ECG 5 – Click to enlarge

Click here to view the video on YouTube.

The Hexaxial Reference System

Adam Thompson, EMT-P — Fri, 02 Nov 2012 21:20:09 +0000

Click to enlarge

ECG Case 4

Adam Thompson, EMT-P — Mon, 29 Oct 2012 15:00:43 +0000

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

trostat, Metoprolol, Ompeprazole, and Lisinopril
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?

ECG Case 4 – Click to enlarge

Click here to view the video on YouTube.

Understanding Bundle Branch Blocks

Adam Thompson, EMT-P — Sun, 28 Oct 2012 02:55:07 +0000

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.

Click here to view the video on YouTube.

The Capnography Tutorial

Adam Thompson, EMT-P — Thu, 25 Oct 2012 19:05:01 +0000

I have put together a capnography tutorial for your education and enjoyment. The videos below are the capnography tutorial. There are 7 lessons, consisting of relatively short videos.

Enjoy.

Adam Thompson, EMT-P

Click here to view the video on YouTube.

ECG Case 3

Adam Thompson, EMT-P — Wed, 24 Oct 2012 20:57:06 +0000

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.

S – Chest palpitations and dizziness (both subsided prior to arrival)
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
BP: 118/74
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?

ECG Case 3 – Click to Enlarge

Watch video below for full case review.

Click here to view the video on YouTube.