Cocaine Overdose Presents with Wide Complex Tachycardia

A 45 year old male with unknown medical history was taken into police custody under concern for trafficking illegal drugs. While he was in the back of the squad car he told the police he had swallowed a large amount of cocaine and may need to go to the hospital.  Not long afterwards he became […]

January 25, 2016

Shock, ST-Segment Elevation, and Massive Pulmonary Embolism

EMS was dispatched to a 48-year-old female having a seizure. As they walked into the residence the patient was laying on the couch, not responding to commands. Her carotid pulse was palpable but the radial was absent. She was noted to be cyanotic and breath sounds were clear. Side stream ETCO2 was placed under a […]

January 18, 2016

Acute Inferior STEMI with Right Ventricular Infarction and Cardiac Arrest

EMS (with physician on board) is dispatched to a 42-year-old male with a chief complaint of chest pain and “possible heart attack.” The patient is found lying on the couch. He appears to be reasonably comfortable and indicates that “the pain has eased a bit” since EMS was contacted. While the patient is being undressed […]

January 11, 2016

Chest Pain and Transient ST-Segment Elevation

EMS was called to an office building for a 61-year-old male complaining of chest pain. Just prior to EMS arrival the patient became nauseated and lightheaded. When they found him he was lying supine on the floor and appeared ashen. Onset: 45 minutes ago following a meeting with an important client Provoke: Nothing makes the […]

January 3, 2016

Syncope with Acute Inferior STEMI and 3 Different AV Blocks

This is a case from the “old days” when prehospital 12-lead ECGs were still a bit of a novelty. Many of the details have been lost to time but patient’s heart rhythms will be the focus of this review. The patient was a young woman in her late 40s who presented with syncope while playing […]

December 28, 2015