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S1Q3T3 on ECG - Pulmonary Embolism Until Proven Otherwise

- Sam Ghali, M.D.
@EM_RESUS

#S1Q3T3 #ECG #EKG #Electrocardiogram #Cardiology
S1Q3T3 on ECG - ... Pulmonary Embolism ... @EM_RESUS #S1Q3T3 ... #ECG #EKG #Electrocardiogram ... #Cardiology #Clinical
ECG changes in Pulmonary Embolism
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Sinus tachycardia 
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Complete or incomplete RBBB 
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ECG changes in Pulmonary ... Embolism - Sinus ... #Embolism #AcutePE ... Electrocardiogram #S1Q3T3 ... #EKG #Findings
#EKG taken on a patient with an acute pulmonary embolism with right heart strain showing tachycardia,
#EKG taken on a ... with an acute pulmonary ... embolism with right ... branch block, ST ... #criticalcare #cardiology
EKG in Acute Pulmonary Embolism
The sensitivity and specificity for EKG findings in acute PE are low.
EKG
EKG in Acute Pulmonary ... Embolism The sensitivity ... • Non-specific ST-T ... #EKG #Pulmonary ... #diagnosis #cardiology
Shock - Differential Diagnosis Framework
 - MAP <65. SBP <90, drop in SBP > 40
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Failure, Toxins/Medications ... • Obstructive: Pulmonary ... Embolism, Tension ... ) UOP > 0.5 cc/kg ... algorithm #treatment #management
Medical Management of Acute RV Failure
 • Evaluate and Treat Etiology of RV Failure [e.g. Acute
Medical Management ... of RV Failure [e.g ... involving RV, Pulmonary ... Embolism] • Evaluate ... rightventricular #cardiology
Pulmonary Embolism Treatment
Systemic Thrombolysis
 - Exclude contraindications.
 - Indications:
   - Massive PE (definite indication)
Pulmonary Embolism ... - Indications ... Low dose 0.5 mg/kg ... #Embolism #Treatment ... #AcutePE #Management
Bradycardia
1) First Steps: IV, O2, Monitors, ECG, Pads on patient, Crash Cart in room. Is patient
-10mcg/min IV Set ... Set pacemaker to ... sedative & pain medication ... #differential #management ... #cardiology
Syncope - Differential Diagnosis Algorithm
Neurocardiogenic:
 • Vasovagal
 • Orthostatic Hypotension
 • Autonomic Neuropathy
 • Situational (micturition,
Respiratory: • Pulmonary ... Embolism • Hypoxia ... • Anemia • Medications ... Tachyarrhythmia: • VT ... Syndrome #Syncope #Cardiology
Endocarditis checklist
Initial evaluation
 • Peripheral blood cultures (three sets at three different sites)
 • Additional culture
endocarditis w/ septic pulmonary ... spleen, brain) Indications ... with multiple embolic ... block (+/- daily EKG ... • Aggressive management