Now that state of the art equipment can be carried in ambulances, prehospital emergency staff are able to perform an ECG soon after arrival on scene, enabling the EMS provider to gather important diagnostic information that can not only guide prehospital therapy but also direct hospital-based treatment. This book exclusively addresses ECGs for prehospital emergencies, ranging from basic rhythm diagnosis to critical care applications of the electrocardiogram and advanced 12-lead ECG interpretation in the ACS patient. It provides self testing traces covering all these conditions seen in…mehr
Now that state of the art equipment can be carried in ambulances, prehospital emergency staff are able to perform an ECG soon after arrival on scene, enabling the EMS provider to gather important diagnostic information that can not only guide prehospital therapy but also direct hospital-based treatment.
This book exclusively addresses ECGs for prehospital emergencies, ranging from basic rhythm diagnosis to critical care applications of the electrocardiogram and advanced 12-lead ECG interpretation in the ACS patient. It provides self testing traces covering all these conditions seen in prehospital and hospital- based environments. It includes 200 randomly presented cases mirroring real life situations, with the answers set out separately together with additional invaluable information.
Written by highly experienced emergency physicians with EMS qualifications and experience, this text is an ideal learning tool for trainees and fully qualified staff alike, including ground EMS advanced life support providers, aeromedical staff, and inter-facility critical care transport personnel.
William Brady, MD Professor of Emergency Medicine, University of Virginia Charlottesvile, VA USA Korin Hudson, MD Assistant Professor of Emergency Medicine, Washington Hospital Center Georgetown University Washington, DC USA Sabina Braithwaite, MD Assistant Professor of Emergency Medicine, University of Virginia Charlottesvile, VA USA Jeffrey Ferguson, MD Assistant Professor of Emergency Medicine, East Carolina University Greenville, NC USA Steven Mitchell, MD Assistant Professor of Emergency Medicine, University of Washington Seattle, WA USA
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List of Contributors ix Foreword xi Preface xiii Section 1 The ECG in Prehospital Patient Care 1 1 Clinical applications of the electrocardiogram (ECG) 3 Robert C. Schutt William J. Brady and Steven H. Mitchell 2 Clinical impact of the electrocardiogram (ECG) 7 Robert C. Schutt William J. Brady and Steven H. Mitchell 3 Interpretation of the electrocardiogram - single- multi- and 12-lead analysis 12 Robert C. Reiser Robert C. Schutt and William J. Brady 4 Variants of the normal lead misplacement and electrocardiographic artifact encountered in clinical practice 17 Robert C. Reiser Robert C. Schutt and William J. Brady Section 2 Cardiac Rhythms and Cardiac Dysrhythmias 23 5 Cardiac rhythms with normal rates 25 Korin B. Hudson and William J. Brady 6 Narrow QRS complex tachycardia 29 Courtney B. Saunders and Jeffrey D. Ferguson 7 Wide QRS complex tachycardia 37 Michael Levy and Francis X. Nolan Jr 8 Bradycardia 44 Korin B. Hudson J. Aidan Boswick and William J. Brady 9 Atrioventricular conduction block 50 Steven H. Mitchell Korin B. Hudson and William J. Brady 10 Intraventricular conduction block: bundle branch block and other conduction abnormalities 54 Steven H. Mitchell Richard B. Utarnachitt and William J. Brady 11 Atrial and ventricular ectopic beats 62 Jeffrey D. Ferguson Michael Levy J. Aidan Boswick and William J. Brady Section 3 Acute Coronary Syndrome and the 12-Lead ECG 67 12 Ischemic heart disease: anatomic and physiologic considerations 69 Peter Pollak Peter Monteleone Kelly Williamson David Carlberg and William J. Brady 13 Historical development of the prehospital electrocardiogram (ECG) 76 Erik Iszkula David Carlberg and William J. Brady 14 Electrocardiographic findings in acute coronary syndrome 79 Peter Monteleone Peter Pollak David Carlberg and William J. Brady Section 4 Special Populations High-Risk Presentation Scenarios and Advanced Electrocardiographic Techniques 95 15 The electrocardiogram in the pediatric patient 97 Robert Rutherford Robin Naples and William J. Brady 16 The electrocardiogram in the poisoned patient 104 Steven H. Mitchell Christopher P. Holstege and William J. Brady 17 The electrocardiogram in hyperkalemia 112 Steven H. Mitchell and William J. Brady 18 Life-threatening electrocardiographic patterns 117 Steven H. Mitchell Richard B. Utarnachitt and William J. Brady 19 The electrocardiogram in patients with implanted devices 122 Amita Sudhir and William J. Brady 20 Electrocardiographic tools in prehospital care 127 Robin Naples Alvin Wang and William J. Brady 21 Wolff-Parkinson-White syndrome 134 William J. Brady 22 Cardiac arrest rhythms 138 Amita Sudhir and William J. Brady Section 5 Electrocardiographic Differential Diagnosis of Common ECG Presentations 145 23 Electrocardiographic differential diagnosis of narrow complex tachycardia 147 Megan Starling and William J. Brady 24 Electrocardiographic differential diagnosis of wide complex tachycardia 152 Amita Sudhir and William J. Brady 25 Electrocardiographic differential diagnosis of bradyarrhythmia 161 Megan Starling and William J. Brady 26 Electrocardiographic differential diagnosis of ST segment elevation 165 Megan Starling and William J. Brady 27 Electrocardiographic differential diagnosis of ST segment depression 176 Amita Sudhir and William J. Brady 28 Electrocardiographic differential diagnosis of T wave abnormalities: the prominent T wave and T wave inversions 183 Amita Sudhir and William J. Brady Index 195
List of Contributors ix Foreword xi Preface xiii Section 1 The ECG in Prehospital Patient Care 1 1 Clinical applications of the electrocardiogram (ECG) 3 Robert C. Schutt William J. Brady and Steven H. Mitchell 2 Clinical impact of the electrocardiogram (ECG) 7 Robert C. Schutt William J. Brady and Steven H. Mitchell 3 Interpretation of the electrocardiogram - single- multi- and 12-lead analysis 12 Robert C. Reiser Robert C. Schutt and William J. Brady 4 Variants of the normal lead misplacement and electrocardiographic artifact encountered in clinical practice 17 Robert C. Reiser Robert C. Schutt and William J. Brady Section 2 Cardiac Rhythms and Cardiac Dysrhythmias 23 5 Cardiac rhythms with normal rates 25 Korin B. Hudson and William J. Brady 6 Narrow QRS complex tachycardia 29 Courtney B. Saunders and Jeffrey D. Ferguson 7 Wide QRS complex tachycardia 37 Michael Levy and Francis X. Nolan Jr 8 Bradycardia 44 Korin B. Hudson J. Aidan Boswick and William J. Brady 9 Atrioventricular conduction block 50 Steven H. Mitchell Korin B. Hudson and William J. Brady 10 Intraventricular conduction block: bundle branch block and other conduction abnormalities 54 Steven H. Mitchell Richard B. Utarnachitt and William J. Brady 11 Atrial and ventricular ectopic beats 62 Jeffrey D. Ferguson Michael Levy J. Aidan Boswick and William J. Brady Section 3 Acute Coronary Syndrome and the 12-Lead ECG 67 12 Ischemic heart disease: anatomic and physiologic considerations 69 Peter Pollak Peter Monteleone Kelly Williamson David Carlberg and William J. Brady 13 Historical development of the prehospital electrocardiogram (ECG) 76 Erik Iszkula David Carlberg and William J. Brady 14 Electrocardiographic findings in acute coronary syndrome 79 Peter Monteleone Peter Pollak David Carlberg and William J. Brady Section 4 Special Populations High-Risk Presentation Scenarios and Advanced Electrocardiographic Techniques 95 15 The electrocardiogram in the pediatric patient 97 Robert Rutherford Robin Naples and William J. Brady 16 The electrocardiogram in the poisoned patient 104 Steven H. Mitchell Christopher P. Holstege and William J. Brady 17 The electrocardiogram in hyperkalemia 112 Steven H. Mitchell and William J. Brady 18 Life-threatening electrocardiographic patterns 117 Steven H. Mitchell Richard B. Utarnachitt and William J. Brady 19 The electrocardiogram in patients with implanted devices 122 Amita Sudhir and William J. Brady 20 Electrocardiographic tools in prehospital care 127 Robin Naples Alvin Wang and William J. Brady 21 Wolff-Parkinson-White syndrome 134 William J. Brady 22 Cardiac arrest rhythms 138 Amita Sudhir and William J. Brady Section 5 Electrocardiographic Differential Diagnosis of Common ECG Presentations 145 23 Electrocardiographic differential diagnosis of narrow complex tachycardia 147 Megan Starling and William J. Brady 24 Electrocardiographic differential diagnosis of wide complex tachycardia 152 Amita Sudhir and William J. Brady 25 Electrocardiographic differential diagnosis of bradyarrhythmia 161 Megan Starling and William J. Brady 26 Electrocardiographic differential diagnosis of ST segment elevation 165 Megan Starling and William J. Brady 27 Electrocardiographic differential diagnosis of ST segment depression 176 Amita Sudhir and William J. Brady 28 Electrocardiographic differential diagnosis of T wave abnormalities: the prominent T wave and T wave inversions 183 Amita Sudhir and William J. Brady Index 195
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