This 96 year old man was taken to the Emergency Department (ED) after an unwitnessed fall at his Nursing Home. He sustained a lacerated scalp. He is not on any anticoagulant drugs. He suffers from moderate dementia, and has recurrent falls.
In the following cases you are given clinical details (Stem) and an ECG for analysis. You may be given additional information e.g X-rays or CT scans or blood test results.
This week we catch up with Bones and meet a man with a broken bone who has a potentially arrhythmogenic heart.
Before the formation of the Australasia College of Emergency Medicine (in 1983) the hospital treatment of acute medical or surgical illnesses or injuries was carried out in so-called "Casualty Departments". These are now called "Emergency Departments"
The most likely mechanism of the tachycardia in the previous case is atrial flutter with an initial 2:1 atrioventricular (AV) conduction, followed by 1:1 AV conduction that produced the BCT (because of aberrant conduction).
The patient is a 28 year old male with no known history of heart disease. He is being treated with sodium valproate for epilepsy.
We are very familiar with the term "electricity", but we do not have an in-depth understanding of its “nature” or its “workings”. However we are all aware that an “electric shock” or a "lightening bolt" can produce a range of effects that range from a minor tingle to a “jolt” to major burns to death.
For each of the following ECGs select the most appropriate finding(s) from the list below. Each option may be used once, more than once or not at all.
The ECGs in this case were kindly provided by Aseem Sabharwal from the Alfred Emergency Department...
This 23 year old man presented with a sore throat
This 33 year old woman was seen in the Emergency Department 12 days ago with epigastric discomfort at rest that resolved after treatment with morphine and antacids. The ECG taken at that time is shown in Figure 1, and an enlarged view of Leads aVF and V3 in Figure 2. Her serum troponin concentration was normal, and she was sent home.
What are the significant findings in this ECG of a 61 year old man who 3 days ago had (a unsuccessful) percutaneous coronary intervention procedure for an acute myocardial infarct, and who has had a recurrence of chest pain
This is the second of four ECGs that have been kindly provided by Dr Alfredo Mori, an Emergency Physician from Melbourne, Australia.
This is the ECG of a 68 year old woman with a past history of hypertension, diabetes mellitus and severe lower back pain who came to hospital complaining of central chest painthat radiated into the back.
SOAP: an acronym for subjective, objective, assessment and plan that can be used to set out a medical record
You are a locum doctor in a rural emergency department that is "..far, far away.." from your usual working environment.
This 77 year old woman presents with a 2 hour history of recurrent episodes of feeling dizzy and "not quite right". She had a permanent pacemaker inserted 3 months ago, but this was removed because of persistent and severe pain at the insertion site of the pacemaker battery.
A 35 year old man presented with new onset palpitations.
Swing low, sweet chariot
Swing low, sweet chariot
Coming for to carry me home,
There are some days, some patients and even some ECGs when the treating team is running on empty, when the brain stem is making the diagnostic and therapeutic decisions and the brain is just humming along.
This 24 year old driver of a car was transferred from another hospital. He had been in a high speed motor vehicle while affected by drugs, and had sustained head and chest injuries. He is drowsy but his vital signs are normal.
Describe the main findings in this ECG