A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.
Figure 1. Index EKG
A 75-year-old female with a past medical history of atrial fibrillation on apixaban, bradycardia, depression, and anxiety presents for a fall. She had an unwitnessed syncopal event preceded by dizziness. The patient is brought into the trauma bay for evaluation.The patient is currently asymptomatic. Vitals signs are as follows: BP 142/65, HR 54, RR 14, SpO2 98% on room air, Temp 36.8C. You get an EKG (Figure 1).
Auden Hafeman DO and Ari Edelheit MD
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A 38-year-old male presents to a community hospital emergency department at 3 a.m. and a rapid response is called to the front of the hospital. You respond, and the patient is alert but diaphoretic, weak, and displaying Levine’s sign (a fist clenched over his chest). His wife states that the chest pain started about 30 min prior to arrival. The patient is brought to your resuscitation bay, and his vital signs are as follows: BP 145/98, HR 99, RR 18, O2 93%. You ask for an EKG when then tech informs you that both of the EKG machines in the ED are broken, and we currently have no way of obtaining a tracing. What do you do in this scenario?
Michael Hohl MD, David Murray MD, and Ari Edelheit MD
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Figure 1. Index EKG
A 53-year-old man with no known medical history presents to the emergency department with three days of progressive shortness of breath and leg swelling. His dyspnea is worse with exertion. He denies chest pain, nausea, vomiting, or diaphoresis. Initial vitals notable for BP 190/95, HR 84, RR 24 and 86% on room air. The patient’s initial EKG (Figure 1) is shown.
Abish Kharel MD and Ari Edelheit MD
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