ErnestT

Paramedic

Called for 80 YO M, fever with diagnosis of UTI and discharge from ED earlier in the day. Pt is AAOx4 but fatigued. 102.9 F, 120s/70s, HR 90 irregular. Wife reports hx of AFib, aortic valve replacement 4 months ago, hx of frequent UTIs. As we are discussing transport decision pt becomes more confused, eyes remain open but he is unresponsive to verbal for roughly a minute. Decision is made to transport. Further assessment done in the truck: BGL 104, RR 25-30, EtCO2 20-25, BP remains unchanged. 12-lead above taken just prior to transport, no change with O2.

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A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?