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The ECG in Prehospital Emergency Care

William J. Brady (Editor), Korin Hudson (Editor), Robin Naples (Editor), Amita Sudhir (Editor), Steven Mitchell (Editor), Robert Reiser (Editor), Jeffrey Ferguson (Editor)
ISBN: 978-1-4051-8577-6
216 pages
January 2013, Wiley-Blackwell
The ECG in Prehospital Emergency Care (1405185775) cover image
Now that state of the art equipment can be carried in ambulances, prehospital emergency staff are able to perform an ECG soon after arrival on scene, enabling the EMS provider to gather important diagnostic information that can not only guide prehospital therapy but also direct hospital-based treatment. 

This book exclusively addresses ECGs for prehospital emergencies, ranging from basic rhythm diagnosis to critical care applications of the electrocardiogram and advanced 12-lead ECG interpretation in the ACS patient.  It provides self testing traces covering all these conditions seen in prehospital and hospital- based environments. It includes 200 randomly presented cases mirroring real life situations, with the answers set out separately together with additional invaluable information.

Written by highly experienced emergency physicians with EMS qualifications and experience, this text is an ideal learning tool for trainees and fully qualified staff alike, including ground EMS advanced life support providers, aeromedical staff, and inter-facility critical care transport personnel.

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List of Contributors, ix

Foreword, xi

Preface, xiii

Section 1 The ECG in Prehospital Patient Care, 1

1 Clinical applications of the electrocardiogram (ECG), 3
Robert C. Schutt, William J. Brady, and Steven H. Mitchell

2 Clinical impact of the electrocardiogram (ECG), 7
Robert C. Schutt, William J. Brady, and Steven H. Mitchell

3 Interpretation of the electrocardiogram – single-, multi-, and 12-lead analysis, 12
Robert C. Reiser, Robert C. Schutt, and William J. Brady

4 Variants of the normal, lead misplacement, and electrocardiographic artifact encountered in clinical practice, 17
Robert C. Reiser, Robert C. Schutt, and William J. Brady

Section 2 Cardiac Rhythms and Cardiac Dysrhythmias, 23

5 Cardiac rhythms with normal rates, 25
Korin B. Hudson and William J. Brady

6 Narrow QRS complex tachycardia, 29
Courtney B. Saunders and Jeffrey D. Ferguson

7 Wide QRS complex tachycardia, 37
Michael Levy and Francis X. Nolan Jr

8 Bradycardia, 44
Korin B. Hudson, J. Aidan Boswick, and William J. Brady

9 Atrioventricular conduction block, 50
Steven H. Mitchell, Korin B. Hudson, and William J. Brady

10 Intraventricular conduction block: bundle branch block and other conduction abnormalities, 54
Steven H. Mitchell, Richard B. Utarnachitt and William J. Brady

11 Atrial and ventricular ectopic beats, 62
Jeffrey D. Ferguson, Michael Levy, J. Aidan Boswick, and William J. Brady

Section 3 Acute Coronary Syndrome and the 12-Lead ECG, 67

12 Ischemic heart disease: anatomic and physiologic considerations, 69
Peter Pollak, Peter Monteleone, Kelly Williamson, David Carlberg, and William J. Brady

13 Historical development of the prehospital electrocardiogram (ECG), 76
Erik Iszkula, David Carlberg, and William J. Brady

14 Electrocardiographic findings in acute coronary syndrome, 79
Peter Monteleone, Peter Pollak, David Carlberg, and William J. Brady

Section 4 Special Populations, High-Risk Presentation Scenarios, and Advanced Electrocardiographic Techniques, 95

15 The electrocardiogram in the pediatric patient, 97
Robert Rutherford, Robin Naples, and William J. Brady

16 The electrocardiogram in the poisoned patient, 104
Steven H. Mitchell, Christopher P. Holstege, and William J. Brady

17 The electrocardiogram in hyperkalemia, 112
Steven H. Mitchell and William J. Brady

18 Life-threatening electrocardiographic patterns, 117
Steven H. Mitchell, Richard B. Utarnachitt, and William J. Brady

19 The electrocardiogram in patients with implanted devices, 122
Amita Sudhir and William J. Brady

20 Electrocardiographic tools in prehospital care, 127
Robin Naples, Alvin Wang, and William J. Brady

21 Wolff-Parkinson-White syndrome, 134
William J. Brady

22 Cardiac arrest rhythms, 138
Amita Sudhir and William J. Brady

Section 5 Electrocardiographic Differential Diagnosis of Common ECG Presentations, 145

23 Electrocardiographic differential diagnosis of narrow complex tachycardia, 147
Megan Starling and William J. Brady

24 Electrocardiographic differential diagnosis of wide complex tachycardia, 152
Amita Sudhir and William J. Brady

25 Electrocardiographic differential diagnosis of bradyarrhythmia, 161
Megan Starling and William J. Brady

26 Electrocardiographic differential diagnosis of ST segment elevation, 165
Megan Starling and William J. Brady

27 Electrocardiographic differential diagnosis of ST segment depression, 176
Amita Sudhir and William J. Brady

28 Electrocardiographic differential diagnosis of T wave abnormalities: the prominent T wave and T wave inversions, 183
Amita Sudhir and William J. Brady

Index, 195

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William Brady, MD
Professor of Emergency Medicine,
University of Virginia
Charlottesvile, VA
USA

Korin Hudson, MD
Assistant Professor of Emergency Medicine,
Washington Hospital Center
Georgetown University
Washington, DC
USA

Sabina Braithwaite, MD
Assistant Professor of Emergency Medicine,
University of Virginia
Charlottesvile, VA
USA

Jeffrey Ferguson, MD
Assistant Professor of Emergency Medicine,
East Carolina University
Greenville, NC
USA

Steven Mitchell, MD
Assistant Professor of Emergency Medicine,
University of Washington
Seattle, WA
USA

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