NAEMSP
JULY 15, 2025
You load him in the back of your ambulance and acquire a 12-lead electrocardiogram (ECG) and it is as follows: You are 5 minutes from a local community hospital and 45 minutes from the tertiary care center with percutaneous coronary intervention (PCI) capabilities. However, the notion of “STEMI equivalents” has gained traction.
Dr. Smith's ECG Blog
JUNE 12, 2025
A 60-something with h/o Coronary Bypass called 911 for acute chest pain. The Zoll algorithm impressively stated: STEMI A paramedic student had the PMCardio AI Queen of Hearts on his phone and this is what it reported: New PMcardio for Individuals App 3.0 Here is the first prehospital ECG: What do you think?
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Dr. Smith's ECG Blog
JANUARY 31, 2025
This ECG pattern is my favorite example of how the STEMI criteria are fundamentally flawed. We have a series of 20 TIMI-0 LAD Occlusions that do meet STEMI criteria. This typically occurs in the setting of a rapidly reperfused coronary artery following a myocardial infarction. There is a de Winter T- wave pattern also in lead I.
Dr. Smith's ECG Blog
DECEMBER 3, 2024
The first EKG was concerning for a Wellen’s-like pattern of subtle reperfusion changes in the setting of stuttering anginal-equivalent symptoms, but none were diagnostic of STEMI or OMI. Later in the night, the patient became bradycardic and developed a Mobitz II pattern , but he remained asymptomatic and hemodynamically stable.
Dr. Smith's ECG Blog
APRIL 14, 2017
On arrival, she still had chest pressure and this ECG was recorded: Atrial fibrillation with rapid ventricular response Diffuse ST depression, as with prehospital ECG Is the ischemia a result of atrial fib with RVR, or is atrial fib with RVR just exacerbating ischemia whose source is acute coronary syndrome? She did well overnight.
Peter Canning
JUNE 8, 2025
Instead of floating a wire into the heart to remove a clock in a blocked coronary artery to restore blood flow, we were floating wires into people’s brains to remove the clot obstructing blood flow –a life-saving procedure. One of the best things about thrombectomies is they have extended the stroke window out to 24 hours. Again, true.
JEMS
JULY 7, 2025
Rapid re-perfusion of the coronary arteries is essential to save at risk myocardium from infarction in patients with acute coronary artery occlusion. ST-segment Elevation Myocardial Infarction (STEMI) criteria have been the traditional method of cath lab activation.
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