ECG in Prehospital Emergency Care

William Brady, MDProfessor of Emergency Medicine, University of VirginiaCharlottesvile, VAUSAKorin Hudson, MDAssistant Professor of Emergency Medicine,Washington Hospital CenterGeorgetown UniversityWashington, DCUSA Sabina Braithwaite, MDAssistant Professor of Emergency Medicine,University of VirginiaCharlottesvile, VAUSA Jeffrey Ferguson, MDAssistant Professor of Emergency Medicine,East Carolina UniversityGreenville, NCUSA Steven Mitchell, MDAssistant Professor of Emergency Medicine,University of WashingtonSeattle, WAUSA

• List of Contributors ixForeword xiPreface xiiiSection 1 The ECG in Prehospital Patient Care 11 Clinical applications of the electrocardiogram (ECG) 3Robert C. Schutt William J. Brady and Steven H. Mitchell2 Clinical impact of the electrocardiogram (ECG) 7Robert C. Schutt William J. Brady and Steven H. Mitchell3 Interpretation of the electrocardiogram – single-, multi-, and 12-lead analysis 12Robert C. Reiser Robert C. Schutt and William J. Brady4 Variants of the normal, lead misplacement, and electrocardiographic artifact encountered in clinical practice 17Robert C. Reiser Robert C. Schutt and William J. BradySection 2 Cardiac Rhythms and Cardiac Dysrhythmias 235 Cardiac rhythms with normal rates 25Korin B. Hudson and William J. Brady6 Narrow QRS complex tachycardia 29Courtney B. Saunders and Jeffrey D. Ferguson7 Wide QRS complex tachycardia 37Michael Levy and Francis X. Nolan Jr8 Bradycardia 44Korin B. Hudson J. Aidan Boswick and William J. Brady9 Atrioventricular conduction block 50Steven H. Mitchell Korin B. Hudson and William J. Brady10 Intraventricular conduction block: bundle branch block and other conduction abnormalities 54Steven H. Mitchell Richard B. Utarnachitt and William J. Brady11 Atrial and ventricular ectopic beats 62Jeffrey D. Ferguson Michael Levy J. Aidan Boswick and William J. BradySection 3 Acute Coronary Syndrome and the 12-Lead ECG 6712 Ischemic heart disease: anatomic and physiologic considerations 69Peter Pollak Peter Monteleone Kelly Williamson David Carlberg and William J. Brady13 Historical development of the prehospital electrocardiogram (ECG) 76Erik Iszkula David Carlberg and William J. Brady14 Electrocardiographic findings in acute coronary syndrome 79Peter Monteleone Peter Pollak David Carlberg and William J. BradySection 4 Special Populations High-Risk Presentation Scenarios and Advanced Electrocardiographic Techniques 9515 The electrocardiogram in the pediatric patient 97Robert Rutherford Robin Naples and William J. Brady16 The electrocardiogram in the poisoned patient 104Steven H. Mitchell Christopher P. Holstege and William J. Brady17 The electrocardiogram in hyperkalemia 112Steven H. Mitchell and William J. Brady18 Life-threatening electrocardiographic patterns 117Steven H. Mitchell Richard B. Utarnachitt and William J. Brady19 The electrocardiogram in patients with implanted devices 122Amita Sudhir and William J. Brady20 Electrocardiographic tools in prehospital care 127Robin Naples Alvin Wang and William J. Brady21 Wolff-Parkinson-White syndrome 134William J. Brady22 Cardiac arrest rhythms 138Amita Sudhir and William J. BradySection 5 Electrocardiographic Differential Diagnosis of Common ECG Presentations 14523 Electrocardiographic differential diagnosis of narrow complex tachycardia 147Megan Starling and William J. Brady24 Electrocardiographic differential diagnosis of wide complex tachycardia 152Amita Sudhir and William J. Brady25 Electrocardiographic differential diagnosis of bradyarrhythmia 161Megan Starling and William J. Brady26 Electrocardiographic differential diagnosis of ST segment elevation 165Megan Starling and William J. Brady27 Electrocardiographic differential diagnosis of ST segment depression 176Amita Sudhir and William J. Brady28 Electrocardiographic differential diagnosis of T wave abnormalities: the prominent T wave and T wave inversions 183Amita Sudhir and William J. BradyIndex 195