Current ECG Podcast

In this episode, Dave is joined by Brad Reid to discuss Medical Math and how you can be sure that you are making accurate calculations at 3 o'clock in the morning when you are hungry and tired!

Brad is an Advanced Care Paramedic in Nova Scotia and currently is the Program Manager for Medavie HealthEd that delivers Primary and Advanced Care Paramedic programs. Brad has worked as a Paramedic in Nova Scotia for 25 years. He also continues to work clinically as a Department Paramedic for the Nova Scotia Health Authority.

Also In This Episode:

• Patient example: 63 Y/O F
• Starting with the basics
• Patient example: Dopamine infusion
• Medical Math
  • What do we need?
  • What information do we have?
  • How much do we need?
  • What is the drip rate?
• Is there another equation? Yes!
• The Clock Method
• The Digital Method

More about Brad:

Brad has been involved in education for over 20 years. Initially delivering programs for St. John Ambulance, Brad helped develop the Maritime School of Paramedicine delivering the first Primary Care Program in 2001. Brad obtained his diploma in Adult Education from St. Francis Xavier University.

Brad has represented Nova Scotia as the Provincial Director, and Vice President for the Society of Prehospital Educators (SPEC) and held the position of Medical Advisor, ACP for the Professional Standards and Accreditation Committee for St. John Ambulance National.

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In this episode, Dave highlights one some consider to be the ultimate imposter- Hyperkalemia. Hyperkalemia is a life threatening electrolyte abnormality that can be easily missed in the emergency setting, and it is vitally important that we can recognize this by interpreting our patients ECG.

Also In This Episode

• ECG example - Diagnosis
• Depolarization - what's happening at the cellular level. You don't want to miss it.
• What is Hyperkalemia?
• ECG example
• Hyperkalemia is a primary cellular problem which is why is produces global changes on the ECG.
• Is that Asystole? Nope it's sinus rhythm in Hyperkalemia "mic drop"!
• Calcium backdoor solution to temporary stabilization of the cardiomyocytes. Buying your patient time to definitive care.
• Potassium levels produce characteristic ECG changes but it's not sharp and point T waves...

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In this episode, Dave is joined by Tarlan Hedayati, MD, FACEP, to discuss STEMI equivalents: ECG patterns that need the Cath Lab.

Dr.Hedayati is a practicing Emergency Physican in Cook County, Chicago. She is also the Associate Professor and Chair of Education for the Emergency Medicine Department.

Also In This Episode

• What are STEMI equivalents?
• STEMI defined
• ECG families
• Case example: 63 female
  • Wellen's waves
• Case example: 66 female
  • STE aVR > V1, STD Diffuse
  • Ask about DAPT
• Case example: 67 male
  • Discordant ST-segments and T-waves
  • Sgarbossa's criteria
  • Sgarbossa-Smith modification
• Case example: Non obstructive CAD
• LBBB
• Case example: 43 male
  • De Winter's waves
• OHCA with ROSC: Who goes to the Cath lab?
• Pattern Recognition: "HOW BAD" is the ECG

Connect with Tarlan Hedayati:

Twitter: @HedayatiMD https://twitter.com/HedayatiMD

Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.

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And Stay Current!

In this episode, Dave presents on some of the ECG interpretation basics and how to avoid being making incorrect interpretation at 3am when you are hungry and tired.

Also In This Episode

• Interpretation basics
• Atrial Fibrillation
• ECG Tracing Example 1 - 3
• Turn the volume up on your monitor
• ECG Tracing Example 4 - 9

Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.

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In this episode, Dave is joined by Amal Mattu, MD, FAAEM, FACEP, to discuss high risk Arrhythmias.

Dr. Mattu is the Professor and Vice Chair, Department of Emergency Medicine, University of Maryland School of Medicine.

Also In This Episode

• Case #1 - 60 yo. woman with weakness
  • Moderate Hyperkalemia
  • Severe Hyperkalemia
• Case #2 - 45 yo. man with lightheadedness, BP 110/60
  • Hyperkalemia (K+ 9.2)
  • Amiodarone infusion
• ECG - 42 yo. man with dyspnea and weakness
• ECG - RRWCT: Severe acidosis (pH
• ECG - RRWCT: Hyperkalemia
• ECG - RRWCT: Pacer with wide QRS
• ECG - RRWCT: Nortriptyline OD
• ECG - RRWCT: Flecainide toxicity

• Case #3 - 37 yo. man with respiratory distress, pulmonary edema...
  • Ventricular Tachycardia Mimics ("Slow V.Tach.")
    • ECG - 42 yo. man presents c/o fever, cough, dyspnea, vomiting
    • ECG - Case 1
    • ECG - Case 2
    • ECG - Case 3
    • ECG - Case 4
    • ECG - Case 5
    • ECG case examples
• Summary

Connect with Dr. Mattu: [email protected]

Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.

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And Stay Current!

In this episode, Dave discusses how it is important as practitioners to understand how blood PH can effect how we manage and treat our patients.

Also In This Episode

• How do we provide oxygen and what is it doing?
• Oxygen disassociation curve
• Acidotic environment
• Alkalotic environment
• The cells need sugar, water, oxygen to survive!

Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.

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In this episode, Dave is joined by Tarlan Hedayati, MD, to discuss Tachycardia.

Dr.Hedayati is a practicing Emergency Physican in Cook County, Chicago. She is also the Associate Professor and Chair of Education for the Emergency Medicine Department.

Also In This Episode

• Defining Tachycardia
• Stable vs. Unstable vs. Cardiac arrest
• Sinus vs. Not sinus
• P and QRS
• Narrow vs. Wide
• Regular vs. Irregular
• History of presenting illness matters
• ECG Tracing example 1,2,3,4
  • What's the polarity?
  • LBBB
  • Regular and wide
  • SVT with LBBB
• Fusion Beat: Wide QRS + Narrow QRS
• Capture Beat: Narrow QRS
• Treatment
  • Procainamide vs. Amiodarone
• Irregular wide complex Tachycardia
• ECG Tracing example 5
  • Polymorphic VT
• ECG Tracing example 6
  • A Fib with RVR and LBBB
• ECG Tracing example 7
  • A Fib with RVR in WPW
• ECG Tracing example 8
  • Sometimes the QRS is too wide
• ECG Tracing example 9
  • Syncope
• ECG Tracing example 10
  • Fascicular VT

Connect with Tarlan Hedayati:

Twitter: @HedayatiMD https://twitter.com/HedayatiMD

Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.

Subscribe now at CurrentECG.com

And Stay Current!

In this episode, Dave is joined by Tarlan Hedayati, MD, to discuss Bradycardias and Blocks.

Dr.Hedayati is a practicing Emergency Physican in Cook County, Chicago. She is also the Associate Professor and Chair of Education for the Emergency Medicine Department.

Also In This Episode

• Defining Bradycardia
• Stable vs. unstable
• Sinus vs. not sinus
• Narrow vs. wide
• AV Blocks
• ECG Tracing example 1
  • 1st Degree AV Block
  • 2nd Degree AV Block
• ECG Tracing example 2
• ECG Tracing example 3
  • 3rd Degree Heart Block
• What is causing this Bradycardia?
• ECG Tracing example 4
  • Bradycardia in ACS
• Clinical context
  • ECG Tracing example 5
• The Brady Bunch
  • Beta Blockers, CCB, Clonidine, Digoxin
• ECG Tracing example 6
  • Hyperkalemia
• ECG Tracing example 7
  • Slow and narrow
• ECG Tracing example 8
  • Regular and wide
• ECG Tracing example 9
  • Osborn waves
• ECG Challenge
• The Cardiac Monitor is a dirty rotten scoundrel

Connect with Tarlan Hedayati:

Twitter: @HedayatiMD https://twitter.com/HedayatiMD

Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.

Subscribe now at CurrentECG.com

And Stay Current!

In this episode, Dave discusses global ST Segment elevation, the flawed line of thinking that leads us to think "it must be Pericarditis", and how to differentiate between Acute Coronary Syndrome and Pericarditis.

Also In This Episode

• Pericarditis - signs and symptoms
• ECG Tracing example 1
• ECG Tracing example 2
• Morphology counts!
• ECG Tracing example 3,4
• ST Segment depression in aVL - reciprocal change
• ECG Tracing example 5
• What about the ST Segment depression in aVR or V1, what does that mean?
• ECG Tracing example 6

Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.

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And Stay Current!

In this episode, Dave talks about augmented Vector Right (aVR). Many of us have been told, "Don't bother using lead aVR as part of your interpretation, you can't see anything in lead aVR, it won't give you any useful information." Nothing could be further from the truth.

Also In This Episode

• Lead aVR, the forgotten lead
• Looking down through the heart, an intracavitary lead
• True trifurcation of the left main
• ST-Elevation in lead aVR and SD-Depression everywhere else
• Injury vectors
• ECG Tracing example 1
• What about triple vessel disease?
• ECG Tracing example 2,3,4,5,6

Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.

Subscribe now at CurrentECG.com

And Stay Current!