Ep.42 - Posterior RCA Occlusions with Matt Pigott

This episode features Matt Pigott from Medic Minute with Matt to share his insights about Posterior RCA Occlusions.  Also In This Episode Anatomy of the RCA Scenario - 62 Y/O F C/C of nausea Standard 12 lead placement Modified 12 lead Posterior RCA diagnosis LAD Occlusions Anatomy of the LAD Scenario - 58 Y/O m C/C of chest pain Hyperacute T waves         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

This episode features Matt Pigott from Medic Minute with Matt to share his insights about 12 Lead ECG and Coronary Anatomy.  Also In This Episode Before you get started Looking at your 12 Lead How does this reflect Coronary Anatomy? Changes in morphology Perfusion issue Blood flow through the heart Electrical issue Electrolyte issue Cardiac action potential PQRST segment "STEMI mimics" RCA Occlusions 55 y/o patient case example(s) Proximal or Distal?   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

On this episode Dave shares about acute coronary syndrome and some of the important ECG shapes and morphologies that can occur in the very beginnings of the injury to the Cardiomyocytes of your heart.   Also In This Episode Abnormally wide T waves ECG Tracing examples Don't get confused with Hyperkalemia    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!  

On this episode Dave is joined by Dr. Jerry W. Jones, MD FACEP FAAEM, to discuss why ST elevation is not always an infarction. Dr. Jones will highlight why we need to think about morphology and shape when interpreting ECGs and why reciprocal changes are just as important as the primary changes and more!    Dr. Jones is the CEO and Founder of Medicus of Houston. Medicus of Houston is a continuing medical education company that specializes in advanced ECG interpretation and instruction.  He is a Board-certified emergency physician, author, speaker, instructor and and internationally-recognized expert in electrocardiography. Dr. Jones is a diplomate of the American Board of Emergency Medicine who has practiced internal medicine and emergency medicine for over 40 years. Also In This Episode How to diagnose real infarctions How ischemia damages the cell Cells creating electrical current How electrical current creates is responsible for ST depression and elevation Systolic and Diastolic currents of injury How not to confuse subendocardial ischemia with reciprocal change    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, FACEP, to discuss how to decipher dysrhythmias in devices such as Pacemakers and ICD's. Dr. Hedayati is a practicing Emergency Physician in Cook County, Chicago. She is also the Associate Professor and Chair of Education for the Emergency Medicine Department.  Also In This Episode What does normal paced rhythm look like? ECG Tracing example Failure to Pace What does a magnet do to a Pacemaker? Failure to Capture ECG Tracing examples Pacemaker X-Ray examples Twiddler's Syndrome  Failure to Sense ECG Tracing examples Pacemaker Mediated Tachycardia Runaway Pacemaker Magnet in ICD's  Review - Look at the ECG Look at the rate? Are there pacer spikes? Are there p's and/or QRS after every spike? Are the spikes appropriate? . 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 shares about moving away from the concept of ST-Elevation Myocardial Infarction (STEMI) and focusing on Occlusion Myocardial Infarction (OMI).   Also In This Episode: OMI vs. STEMI Patient Case: 70 YO Male De Winter's T Waves ECG Tracing example ECG Diagnostic criteria ECG Tracing examples Review - Patient Case: 70 YO Male Activate Cath Lab Take home points   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 talks about End-tidal CO2 (EtCO2), and how to use Capnography to better assess and treat your patients. Also In This Episode: What is Capnography? Patient Case: 25 YO Male When CO2 is not exhaled effectively Oxygenation and Ventilation 4 phases of EtCO2 EtCO2 and airway management  Using EtCO2 during cardiac arrest  Supporting graphs and stats Waveform and EtCO2 examples - What do you think is happening with this patient? EtCO2 + COPD - Shark fin pattern Waveform examples - troubleshooting Head injury Patient Case: 25 YO Male - revisit   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! .

On this episode Dave is joined by Dr. Jerry W. Jones, MD FACEP FAAEM. Dr. Jones is the CEO and Founder of Medicus of Houston. Medicus of Houston is a continuing medical education company that specializes in advanced ECG interpretation and instruction.  He is a Board-certified emergency physician, author, speaker, instructor and and internationally-recognized expert in electrocardiography. Dr. Jones is a diplomate of the American Board of Emergency Medicine who has practiced internal medicine and emergency medicine for over 40 years. Also In This Episode What is a Reciprocal Change?  The rules of Reciprocal Change Only in the same plane as ST elevation The leads manifesting reciprocal change should be as close to 180 degrees away from the leads with ST elevation as possible. ST Elevation / Reciprocal Pairs Inferior Epicardial Ischemia with Reciprocal Change Basolateral Epicardial Ischemia with Reciprocal Change Posterior / Lateral Epicardial Ischemia  Epicardial Ischemia with Reciprocal Change ECG Tracing example An impulse travelling perpendicular to a lead axis cannot be seen in that lead.  ECG Tracing example Ventricular Aneurysm  The Problem with Anterior ST Elevation LAD Occlusion and Reciprocal Changes ECG Tracing examples Acute Pericarditis  Danger is hiding in Reciprocal changes ECG Tracing example ECG Tracing example Subendocardial Ischemia or Reciprocal Change? ECG Tracing examples of Reciprocal changes ECG Tracing examples of Subendocardial Ischemia Six points to remember Dave's take-home points    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, FACEP, to discuss how to differentiate between Pseudo PEA and True PEA. Dr. Hedayati is a practicing Emergency Physician in Cook County, Chicago. She is also the Associate Professor and Chair of Education for the Emergency Medicine Department.  Also In This Episode Patient Case: 57 YO Male POC Ultrasound Pulse checks, are fingers are dumb POCUS for Pulse FEEL for cardiac activity (Focused Echocardiographic Evaluation in Life support)  The downside of POCUS POCUS in the emergency department CASA (Cardiac Arrest Sonographic Assessment) Tamponade RV strain Motion PEA Evaluation Pressor Infusions vs. Standard ACLS PEA Bottom line: POCUS & minimize pauses   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 shares the importance of practicing quality CPR with the goal of being the 'ultimate compressor'.  Also In This Episode: Patient case which deteriorates to cardiac arrest- AHA/ILCOR ECC guidelines to begin immediate chest compressions and application of the cardiac monitor with an attempt at defibrillation. Work as a team on the choreography of resuscitation. Ensuring no one provider has a cognitive overload and is able to focus on a specific assigned task. Ensure the provider who is performing the skill of chest compressions is able to focus on the appropriate rate, minimizing pauses, and allowing for complete chest recoil. CPP - Coronary Perfusion Pressure is the key to providing the cardiomyocytes with the sugar, water, oxygen they need to survive by perfusing the coronary ostia and building CPP.  Post ROSC care should include maintaining a systolic blood pressure of at least 90mmhg, 02 sats between 94-99%, patient normothermia, 12 lead ECG interpretation and finally working with other health care providers on a coordinated transfer of care.   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!