On this episode Dave is joined by Dr. Jerry W. Jones, MD FACEP FAAEM, to discuss why ST elevation is not always an infarction. Dr. Jones will highlight why we need to think about morphology and shape when interpreting ECGs and why reciprocal changes are just as important as the primary changes and more!    Dr. Jones is the CEO and Founder of Medicus of Houston. Medicus of Houston is a continuing medical education company that specializes in advanced ECG interpretation and instruction.  He is a Board-certified emergency physician, author, speaker, instructor and and internationally-recognized expert in electrocardiography. Dr. Jones is a diplomate of the American Board of Emergency Medicine who has practiced internal medicine and emergency medicine for over 40 years. Also In This Episode How to diagnose real infarctions How ischemia damages the cell Cells creating electrical current How electrical current creates is responsible for ST depression and elevation Systolic and Diastolic currents of injury How not to confuse subendocardial ischemia with reciprocal change    Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.  Subscribe now at CurrentECG.com  And Stay Current!  

Current ECG Podcast

Ep.39 - ST Elevation is NOT Infarction

In this episode, Dave is joined by Tarlan Hedayati, MD, FACEP, to discuss how to decipher dysrhythmias in devices such as Pacemakers and ICD's. Dr. Hedayati is a practicing Emergency Physician in Cook County, Chicago. She is also the Associate Professor and Chair of Education for the Emergency Medicine Department.  Also In This Episode What does normal paced rhythm look like? ECG Tracing example Failure to Pace What does a magnet do to a Pacemaker? Failure to Capture ECG Tracing examples Pacemaker X-Ray examples Twiddler's Syndrome  Failure to Sense ECG Tracing examples Pacemaker Mediated Tachycardia Runaway Pacemaker Magnet in ICD's  Review - Look at the ECG Look at the rate? Are there pacer spikes? Are there p's and/or QRS after every spike? Are the spikes appropriate? . Connect with Tarlan Hedayati:  Twitter: @HedayatiMD https://twitter.com/HedayatiMD   Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.  Subscribe now at CurrentECG.com  And Stay Current!

Ep.38 - Can You Keep Up with the Pace?...Pacemakers and ICD's with Dr. Hedayati

In this episode, Dave shares about moving away from the concept of ST-Elevation Myocardial Infarction (STEMI) and focusing on Occlusion Myocardial Infarction (OMI).   Also In This Episode: OMI vs. STEMI Patient Case: 70 YO Male De Winter's T Waves ECG Tracing example ECG Diagnostic criteria ECG Tracing examples Review - Patient Case: 70 YO Male Activate Cath Lab Take home points   Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.  Subscribe now at CurrentECG.com  And Stay Current! .

Ep.37 - De Winter's T Waves: OMI vs STEMI

In this episode, Dave talks about End-tidal CO2 (EtCO2), and how to use Capnography to better assess and treat your patients. Also In This Episode: What is Capnography? Patient Case: 25 YO Male When CO2 is not exhaled effectively Oxygenation and Ventilation 4 phases of EtCO2 EtCO2 and airway management  Using EtCO2 during cardiac arrest  Supporting graphs and stats Waveform and EtCO2 examples - What do you think is happening with this patient? EtCO2 + COPD - Shark fin pattern Waveform examples - troubleshooting Head injury Patient Case: 25 YO Male - revisit   Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.  Subscribe now at CurrentECG.com  And Stay Current! .

Ep.36 - Capnography...Smoke from the Flames of Cellular Metabolism!

On this episode Dave is joined by Dr. Jerry W. Jones, MD FACEP FAAEM. Dr. Jones is the CEO and Founder of Medicus of Houston. Medicus of Houston is a continuing medical education company that specializes in advanced ECG interpretation and instruction.  He is a Board-certified emergency physician, author, speaker, instructor and and internationally-recognized expert in electrocardiography. Dr. Jones is a diplomate of the American Board of Emergency Medicine who has practiced internal medicine and emergency medicine for over 40 years. Also In This Episode What is a Reciprocal Change?  The rules of Reciprocal Change Only in the same plane as ST elevation The leads manifesting reciprocal change should be as close to 180 degrees away from the leads with ST elevation as possible. ST Elevation / Reciprocal Pairs Inferior Epicardial Ischemia with Reciprocal Change Basolateral Epicardial Ischemia with Reciprocal Change Posterior / Lateral Epicardial Ischemia  Epicardial Ischemia with Reciprocal Change ECG Tracing example An impulse travelling perpendicular to a lead axis cannot be seen in that lead.  ECG Tracing example Ventricular Aneurysm  The Problem with Anterior ST Elevation LAD Occlusion and Reciprocal Changes ECG Tracing examples Acute Pericarditis  Danger is hiding in Reciprocal changes ECG Tracing example ECG Tracing example Subendocardial Ischemia or Reciprocal Change? ECG Tracing examples of Reciprocal changes ECG Tracing examples of Subendocardial Ischemia Six points to remember Dave's take-home points    Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.  Subscribe now at CurrentECG.com  And Stay Current!  

Ep.35 - Don't Look Here, Look Over There, That's Where the Problem Is! - Reciprocal Changes with Dr. Jones

In this episode, Dave is joined by Tarlan Hedayati, MD, FACEP, to discuss how to differentiate between Pseudo PEA and True PEA. Dr. Hedayati is a practicing Emergency Physician in Cook County, Chicago. She is also the Associate Professor and Chair of Education for the Emergency Medicine Department.  Also In This Episode Patient Case: 57 YO Male POC Ultrasound Pulse checks, are fingers are dumb POCUS for Pulse FEEL for cardiac activity (Focused Echocardiographic Evaluation in Life support)  The downside of POCUS POCUS in the emergency department CASA (Cardiac Arrest Sonographic Assessment) Tamponade RV strain Motion PEA Evaluation Pressor Infusions vs. Standard ACLS PEA Bottom line: POCUS & minimize pauses   Connect with Tarlan Hedayati:  Twitter: @HedayatiMD https://twitter.com/HedayatiMD   Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.  Subscribe now at CurrentECG.com  And Stay Current!

Ep.34 - All PEA is not the Same: Pseudo PEA vs. True PEA with Tarlan Hedayati, MD, FACEP

In this episode, Dave shares the importance of practicing quality CPR with the goal of being the 'ultimate compressor'.  Also In This Episode: Patient case which deteriorates to cardiac arrest- AHA/ILCOR ECC guidelines to begin immediate chest compressions and application of the cardiac monitor with an attempt at defibrillation. Work as a team on the choreography of resuscitation. Ensuring no one provider has a cognitive overload and is able to focus on a specific assigned task. Ensure the provider who is performing the skill of chest compressions is able to focus on the appropriate rate, minimizing pauses, and allowing for complete chest recoil. CPP - Coronary Perfusion Pressure is the key to providing the cardiomyocytes with the sugar, water, oxygen they need to survive by perfusing the coronary ostia and building CPP.  Post ROSC care should include maintaining a systolic blood pressure of at least 90mmhg, 02 sats between 94-99%, patient normothermia, 12 lead ECG interpretation and finally working with other health care providers on a coordinated transfer of care.   Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.  Subscribe now at CurrentECG.com  And Stay Current!

Ep.33 - The Ultimate Compressor

In this episode, Dave is joined by Brad Reid to discuss Medical Math and how you can be sure that you are making accurate calculations at 3 o'clock in the morning when you are hungry and tired! Brad is an Advanced Care Paramedic in Nova Scotia and currently is the Program Manager for Medavie HealthEd that delivers Primary and Advanced Care Paramedic programs. Brad has worked as a Paramedic in Nova Scotia for 25 years. He also continues to work clinically as a Department Paramedic for the Nova Scotia Health Authority.   Also In This Episode: Patient example: 63 Y/O F Starting with the basics Patient example: Dopamine infusion Medical Math What do we need? What information do we have? How much do we need? What is the drip rate? Is there another equation? Yes! The Clock Method The Digital Method   More about Brad: Brad has been involved in education for over 20 years. Initially delivering programs for St. John Ambulance, Brad helped develop the Maritime School of Paramedicine delivering the first Primary Care Program in 2001. Brad obtained his diploma in Adult Education from St. Francis Xavier University. Brad has represented Nova Scotia as the Provincial Director, and Vice President for the Society of Prehospital Educators (SPEC) and held the position of Medical Advisor, ACP for the Professional Standards and Accreditation Committee for St. John Ambulance National.   Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.  Subscribe now at CurrentECG.com  And Stay Current!

Ep.32 - Feel The Squeeze...Oh No! It's Medical Math

In this episode, Dave highlights one some consider to be the ultimate imposter- Hyperkalemia. Hyperkalemia is a life threatening electrolyte abnormality that can be easily missed in the emergency setting, and it is vitally important that we can recognize this by interpreting our patients ECG.  Also In This Episode ECG example - Diagnosis  Depolarization - what's happening at the cellular level. You don't want to miss it. What is Hyperkalemia? ECG example Hyperkalemia is a primary cellular problem which is why is produces global changes on the ECG. Is that Asystole? Nope it's sinus rhythm in Hyperkalemia "mic drop"! Calcium backdoor solution to temporary stabilization of the cardiomyocytes. Buying your patient time to definitive care. Potassium levels produce characteristic ECG changes but it's not sharp and point T waves...   Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.  Subscribe now at CurrentECG.com  And Stay Current!

Ep.31 - Hyperkalemia with a Cellular Twist You Can't Miss!!! Klein's Version!

In this episode, Dave is joined by Tarlan Hedayati, MD, FACEP, to discuss STEMI equivalents: ECG patterns that need the Cath Lab. Dr.Hedayati is a practicing Emergency Physican in Cook County, Chicago. She is also the Associate Professor and Chair of Education for the Emergency Medicine Department.  Also In This Episode What are STEMI equivalents? STEMI defined ECG families Case example: 63 female Wellen's waves Case example: 66 female STE aVR > V1, STD Diffuse Ask about DAPT Case example: 67 male Discordant ST-segments and T-waves Sgarbossa's criteria  Sgarbossa-Smith modification  Case example: Non obstructive CAD LBBB Case example: 43 male De Winter's waves OHCA with ROSC: Who goes to the Cath lab? Pattern Recognition: "HOW BAD" is the ECG Connect with Tarlan Hedayati:  Twitter: @HedayatiMD https://twitter.com/HedayatiMD   Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.  Subscribe now at CurrentECG.com  And Stay Current!

Ep.30 - STEMI Equivalents You Can't Miss with Tarlan Hedayati, MD, FACEP

In this episode, Dave presents on some of the ECG interpretation basics and how to avoid being making incorrect interpretation at 3am when you are hungry and tired.   Also In This Episode Interpretation basics Atrial Fibrillation ECG Tracing Example 1 - 3 Turn the volume up on your monitor ECG Tracing Example 4 - 9   Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.  Subscribe now at CurrentECG.com  And Stay Current!

Ep.29 - Pearls and Tricks when You're Tired

In this episode, Dave is joined by Amal Mattu, MD, FAAEM, FACEP, to discuss high risk Arrhythmias. Dr. Mattu is the Professor and Vice Chair, Department of Emergency Medicine, University of Maryland School of Medicine.   Also In This Episode Case #1 - 60 yo. woman with weakness Moderate Hyperkalemia Severe Hyperkalemia Case #2 - 45 yo. man with lightheadedness, BP 110/60 Hyperkalemia (K+ 9.2) Amiodarone infusion ECG - 42 yo. man with dyspnea and weakness ECG - RRWCT: Severe acidosis (pH < 7.1) ECG - RRWCT: Hyperkalemia ECG - RRWCT: Pacer with wide QRS ECG - RRWCT: Nortriptyline OD ECG - RRWCT: Flecainide toxicity   Case #3 - 37 yo. man with respiratory distress, pulmonary edema... Ventricular Tachycardia Mimics ("Slow V.Tach.") ECG - 42 yo. man presents c/o fever, cough, dyspnea, vomiting ECG - Case 1 ECG - Case 2 ECG - Case 3 ECG - Case 4 ECG - Case 5 ECG case examples Summary   Connect with Dr. Mattu: amalmattu@comcast.net   Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.  Subscribe now at CurrentECG.com  And Stay Current!

Ep.28 - High Risk Arrhythmias with Amal Mattu, MD, FAAEM, FACEP

In this episode, Dave discusses how it is important as practitioners to understand how blood PH can effect how we manage and treat our patients. Also In This Episode How do we provide oxygen and what is it doing? Oxygen disassociation curve Acidotic environment Alkalotic environment The cells need sugar, water, oxygen to survive!   Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.  Subscribe now at CurrentECG.com  And Stay Current!

Ep.27 - PH & Oxygen Delivery: An A-HA Moment

In this episode, Dave is joined by Tarlan Hedayati, MD, to discuss Tachycardia. Dr.Hedayati is a practicing Emergency Physican in Cook County, Chicago. She is also the Associate Professor and Chair of Education for the Emergency Medicine Department.  Also In This Episode Defining Tachycardia Stable vs. Unstable vs. Cardiac arrest Sinus vs. Not sinus  P and QRS Narrow vs. Wide Regular vs. Irregular History of presenting illness matters ECG Tracing example 1,2,3,4 What's the polarity? LBBB Regular and wide SVT with LBBB Fusion Beat: Wide QRS + Narrow QRS Capture Beat: Narrow QRS Treatment  Procainamide vs. Amiodarone Irregular wide complex Tachycardia ECG Tracing example 5 Polymorphic VT ECG Tracing example 6 A Fib with RVR and LBBB ECG Tracing example 7 A Fib with RVR in WPW ECG Tracing example 8 Sometimes the QRS is too wide ECG Tracing example 9 Syncope ECG Tracing example 10 Fascicular VT   Connect with Tarlan Hedayati:  Twitter: @HedayatiMD https://twitter.com/HedayatiMD   Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.  Subscribe now at CurrentECG.com  And Stay Current!

Ep.26 - Wide Whacky & Tachy with Tarlan Hedayati, MD

In this episode, Dave is joined by Tarlan Hedayati, MD, to discuss Bradycardias and Blocks. Dr.Hedayati is a practicing Emergency Physican in Cook County, Chicago. She is also the Associate Professor and Chair of Education for the Emergency Medicine Department.  Also In This Episode Defining Bradycardia Stable vs. unstable Sinus vs. not sinus Narrow vs. wide AV Blocks ECG Tracing example 1 1st Degree AV Block  2nd Degree AV Block ECG Tracing example 2 ECG Tracing example 3 3rd Degree Heart Block What is causing this Bradycardia? ECG Tracing example 4 Bradycardia in ACS Clinical context ECG Tracing example 5 The Brady Bunch Beta Blockers, CCB, Clonidine, Digoxin ECG Tracing example 6 Hyperkalemia ECG Tracing example 7 Slow and narrow ECG Tracing example 8 Regular and wide ECG Tracing example 9 Osborn waves ECG Challenge  The Cardiac Monitor is a dirty rotten scoundrel    Connect with Tarlan Hedayati:  Twitter: @HedayatiMD https://twitter.com/HedayatiMD   Subscribe to the video version of this podcast to have access to the visuals that accompany the audio as well as additional tools and resources to help improve your understanding.  Subscribe now at CurrentECG.com  And Stay Current!

Ep.25 - Slow your Roll: Bradycardias and Blocks with Tarlan Hedayati, MD

Welcome to the Current ECG Podcast! You listen to this podcast because you want to advance your ECG Interpretation skills and deliver a higher quality of patient care as a practitioner of Emergency Medicine. This content has been crafted for students and practicing Paramedics, Nurses, Physician Assistants, Physicians, Medical Students at all levels and scopes of practice and Emergency Medicine Educators. You will learn the basics to build a strong ECG foundation and more advanced topics like the importance of understanding Morphology as well as currents of injury and their impact on what you see on an ECG tracing. If you're a student who wants to breakthrough in Emergency Medicine, learn how to work the trucks in the streets, this is for you! If you're a seasoned veteran who wants to brush up on your skills and stay up to date on the most current ECG information, this is for you!

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Current ECG Podcast

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