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Home  >  EMT Products  >  Patient Monitoring  >  ECG Challenge: What in the wide, wide world of sports?
May 18, 2011
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EMS 12-Lead
by Tom Bouthillet

ECG Challenge: What in the wide, wide world of sports?

EMS is called to a nursing home for a 71 year old female with shortness of breath.

By Tom Bouthillet

Editor's note: Check out this month's ECG case study and submit your treatment plan in the comments below. Get it right and you could win an EMS1 T-shirt and bottle opener. Good luck!

--> UPDATED: 06/07/2011 - Patient Follow-Up Posted. CLICK HERE FOR THE ANSWER

This case was submitted by a faithful reader who wishes to remain anonymous.

EMS is called to a nursing home for a 71 year old female with shortness of breath.

On arrival the patient is found lying in bed with her head partially elevated.

She appears acutely ill.

Skin is pasty but warm and moist.

The patient denies chest discomfort but admits to shortness of breath.

Breath sounds: rales are auscultated bilaterally, most prominent in the lung bases

Past medical history: Epilepsy, hypertension, atrial fibrillation, CHF

Medications: Aspirin, simvistatin (Zocor), carbamazepine (Tegretol), atenolol (Tenormin), spironolactone (Aldactone)

Vital signs are assessed.

RR: 40
Pulse: 60
NIBP: 118/84
Temp: 96.8

SpO2: 98 on RA

BGL: 218

The patient is placed on the cardiac monitor.

A 12-lead ECG is captured.

What is your interpretation of these ECGs?

How would you treat this patient and why?

About the author


Tom Bouthillet is a Fire Captain/Paramedic with Hilton Head Island Fire & Rescue, Editor of the EMS 12-Lead blog, host of the Code STEMI web series at First Responders Network, a member of the Editoral Advisory Board of EMS World Magazine, and developer of the 12-Lead ECG Challenge smartphone app. He has taught nationally in the Critical Care Transport (CCEMT-P) program out of UMBC and his writings have been referenced in the American Heart Journal, the Journal of the American College of Cardiology: Cardiovascular Interventions and the EP Lab Digest. Contact Tom at tom.bouthillet@ems1.com.
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