Not all “Paced” EKGs are the same. Let’s look at some of the differences among them.
Continue readingPaced EKGs
Monitor weirdness: concerning, yet oddly satisfying
There is nothing too deep here – and certainly nothing educational. These are just some vitals that caught my eye on the monitor.
Continue readingThe Cylinder Tangent Effect
Sometimes we measure cylindrical(ish) structures on a bedside ultrasound. On some occasions, the patient later gets a radiology performed scan and our measurements don’t match. This could be why.
Continue readingCervical spine badness… maybe?
I recently got some cervical spine X-rays on a patient that had been in a car wreck. You can probably guess what my level of concern was by virtue of the fact that I did not get a CT. I did, however, find something interesting…
X-rays or Ultrasounds for fractures?
Bones are very echogenic, which makes their ultrasound appearance a bright white line that is often easy to see – particularly in the case of superficial long bones. That’s what makes ultrasound a great way to find fractures. Let’s look at some examples.
Continue readingWhat’s the heart rate: follow up
In the last post, I mentioned that I was not sure why there was no palpable pulse from the PVC during ventricular bigeminy. Does the PVC not cause a mechanical contraction at all? Or does it actually cause a contraction that is too weak to feel? I’d mentioned that I could have answered the question with an ultrasound.
It was just a matter of time before this happened again.
Continue readingWhat’s the heart rate?
Here we see a nice example of ventricular bigeminy. Besides the rhythm, do you notice anything strange on the cardiac monitor?
Do the details matter?
Navigating High Sensitivity Troponin Testing: Guidelines, Protocols, and Insights
Our hospital switched to a high sensitivity troponin several months ago. We were given a protocol to use that is a little confusing, so I spent an absurd amount of time reading guidelines to figure out how to safely use this test. This is what I found.
Continue readingWhat’s wrong with these ECGs?
We had something come up twice over the past month or so with our ECGs. Several of the residents had trouble spotting the issue. I bet they were not the only ones. Can you see the problem?
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Searcy EM 