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OMI, NOMI, and EMS: The Case for EMS Recognition of Occlusive MI

NAEMSP

The subsequent diagnosis of an ST-segment elevation myocardial infarction (STEMI) sets forth a cascade of events that typically culminates in the patient being transported to hospital capable of emergent percutaneous coronary intervention (PCI). However, the notion of “STEMI equivalents” has gained traction.

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International Prehospital Medicine Institute Literature Review, July 2025

JEMS

The authors of this retrospective review investigate the efficacy of EFT over a 53-month period from May 1, 2018, to November 1, 2022, utilizing records and data from the Hungarian HEMS service. ST-segment Elevation Myocardial Infarction (STEMI) criteria have been the traditional method of cath lab activation.

E-9-1-1 98
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The ‘One Big Beautiful Bill’—And the EMS Revenue Collapse No One’s Ready For

JEMS

EMS remains underrepresented in national health expenditure discussions despite its frontline role in emergency response, acute care triage, and time-sensitive interventions for trauma, stroke, and STEMI patients. Percent of GDP in 2018 [link] 43. References 1. Emergency Medical Services Systems Development. Myers, V., &

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repost this one as QRS distortion

Dr. Smith's ECG Blog

Some are STEMI-equivalents. Here are some basic concepts before we get into the ECGs: STEMI and NonSTEMI are arbitrary terms that may confuse the clinician. Inferior STEMI with AV Block, Cardiogenic Shock an. The QRS proves it. Posted by Steve Smith at 6:29 AM Email This BlogThis! Patient dies. Atrial Fib with RVR.

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Interns are not (yet) poisoned by the STEMI/NSTEMI paradigm

Dr. Smith's ECG Blog

Now as an intern, he is exceptional at EKG interpretation because he was able to learn of the OMI paradigm and importance of pattern recognition before getting poisoned by years of learning STEMI. This is really a transient OMI (or transient STEMI if one uses that terminology and it has diagnostic ST Elevation).

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‘NSTEMI’ or reperfused OMI? And which lesion is the culprit?

Dr. Smith's ECG Blog

This was interpreted as "inferior STEMI" and the cath lab was activated. Discharge diagnosis was Non-STEMI. The STEMI/NSTEMI dichotomy can make it difficult to identify the culprit lesion, which can be spontaneously reperfused at the time of the angiogram 3. The patient had no further episodes of chest pain.

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A patient with chest pain. (post on Normal ECG)

Dr. Smith's ECG Blog

Some are STEMI-equivalents. Here are some basic concepts before we get into the ECGs: STEMI and NonSTEMI are arbitrary terms that may confuse the clinician. hours of chest pain Chest Pain and Right Bundle Branch Block Is this acute STEMI? Is this inferor STEMI? Cardiologist declines taking patient to the cath lab.

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