Guest guest Posted February 21, 2010 Report Share Posted February 21, 2010 STE in aVR and aVL, or in aVR and V1 are strongly suggestive of LMCA occlusion. This condition has a 70% fatality rate. So getting the patient to a cath lab quickly is the definitive treatment. Thanks to everybody who tried this puzzler. In this patient there was no indication of right sided MI, but doing a right side tracing is never wrong. If you think there's possibly a posterior infarct, you can do posterior leads V7 and V8 to confirm. GG On Feb 21, 2010, at 4:52:10 PM, etaylor27472003 etaylor27472003@...> wrote: Subject: Re: Puzzler Date: February 21, 2010 4:52:10 PM MST To: texasems-l STEMI - Probable poseterior septal infarct, possibly going toward the right side. Recommend a right sided 12 Lead EKG and transport patient to a facility with catherization capabilities ASAP. Pre-hospital care is limited to ASA, oxygen PRN to adequate SP02% of 95% or greater and go easy on the nitro until you get the right sided 12 Lead to verify there is no right sided infarction which would lead to significant hypotensive reaction to nitro. IV NS TKO unless hypotensive and begin with 20cc/kg boluses if systolic pressure is less than 90 mmHg or if radial pulses are not present. Further pain mangement can be conducted using morphine or other analgesic depending on hemodynamic stability of the patient. > > > > From: " Gene Bates " > > Subject: Puzzler > > Date: February 20, 2010 8:12:42 PM MST > > To: " texasems-l " texasems-l > > > Limb lead reversal? > > > > Gene Bates > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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