Cardiologists use calipers. Intensivists write little marks on a page and march them across. Emergency providers fold the ECG in half and hold it up to the light. Or the sun.

 

Fold the tracing in half. Hold up to the light.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Now align the QRS complexes. The rhythm is regular.

2 regular rhythm overlap

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Here is another example.

3 irregular rhythm prelim fold

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Irregular. Cannot line up QRS complexes.

4 irregular rhythm overlap

 

 

 

headache ddx.001

 

emergency clinicians do not rule in migraine or other benign causes of headache. unless the headache is congruent to an established pattern for that patient, the history and physical specifically targets these 13 conditions.

subarachnoid hemorrhage: family history, PCKD, known berry aneurysm, sudden and maximal intensity at onset, posterior location

intracerebral hemorrhage: trauma, coagulopathy, decreased level of consciousness, hypertension

CNS infection: fever, immunocompromise, CNS instrumentation, recent head/face infection, meningismus

increased intracranial pressure: slowly progressive, cancer history, worse in morning, worse with head in dependent position, papilledema

carbon monoxide toxicity: contacts with similar illness, locationality (worse at home or at work)

acute angle closure glaucoma: unilateral anterior location, precipitated by darkness, change in vision, red eye

temporal (giant cell) arteritis: elderly, temporal location, jaw claudication, shoulder girdle symptoms

cervical artery dissection: unilateral pain involving neck/face, trauma history

cerebral venous sinus thrombosis: thrombophilia, neurologic signs/symptoms in non-arterial distribution, eyelid edema, proptosis

hypertensive encephalopathy: altered mentation, marked hypertension, improves with antihypertensive therapy

ENT/dental infection: ear, sinus, dental findings

idiopathic intracranial hypertension: young overweight female, hormone use, vision changes

preeclampsia: late pregnancy or postpartum

EDSOSC Screenshot

 

In acrobat format.

Thanks to pandrus for his assistance.

Bleeding

 

Ten minute screencast describing an expanded ABCs mnemonic.

Mobile phone optimized cheat sheet at emupdates.com/resus.

Slides.

Audio.

Resus Room pic.