ACLS Certification Blog

Oct 13
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Atrial tachycardia and other ectopic rhythms, which originate in the atria, occur outside the sinus nodes, and they create action potentials faster than the sinus node, which enables them to become the primary pacemaker of the heart. When any atrial rate is greater than 100 beats per minute, the term for the rhythm is atrial tachycardia. However, if the rate is less than 100 beats per minute, the term is ectopic atrial rhythm.When the origin of electrical activity is not from the sinus node, the P wave do…
Oct 03
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Here's a special situation for those of you who live in Charlotte, North Carolina. A 78-year old gentleman was being transported from Terminal B to the baggage carousel at the Charlotte Douglas International Airport (www.charlotteairport.com), when he began to complain of feeling light-headed. The astute transportation provider checked his pulse, which was rapid, when all of a sudden our gentleman collapsed. The transportation provider turned off his golf-cart, and he placed the visitor in the supine positi…
Sep 27
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Your patient presents to the emergency department at Duke Regional Hospital (www.dukeregional.org) with crushing retrosternal chest pain for an hour. She has no past medical history. Upon arrival, her blood pressure is 120/85, and she is in sinus rhythm at 80 beats per minute. Examination reveals an S4 heart sound. Lungs are clear, and the rest of the exam is unremarkable, except for her distress. She is diaphoretic. You obtain an ECG, which reveals a 4 mm ST segment elevation in leads II, III, and aVF. Rig…
Sep 18
The patient mentioned in the question of the day displayed an early repolarization pattern on his ECG. This is a common ECG variant, and is defined by J point elevation on ECG of greater than or equal to 0.1 mV in two adjacent leads, which appear as terminal QRS slurring during the transition from the QRS segment to the ST segment, or as a positive deflection on the terminal QRS complex, which appears as a notch, followed by a concave upward ST-segment elevation, with prominent T waves in two or more contig…
Sep 07
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Any discussion of hyperkalemia should begin with the statement that potassium is a critical electrolyte for cellular function of all cells, but when considered with respect to cardiac physiology, its effect is magnified.The myocardial cells depend upon a normal serum potassium level that is between 3.5 and 5.0 mEq/L. The body’s total potassium concentration is much higher than reflected in the serum, because most of the body’s potassium remains within the cells. Understanding the role of potassium in main…
Sep 04
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I recently posted an ECG with diffuse ST segment elevations in all leads. It was the ECG of a patient with pericarditis. Pericarditis can result in an ECG that may appear alarming, if you don’t look carefully.  Find another characteristic ECG below: The disease is an inflammation of the sac that closely adheres to the heart, known as the pericardium.The pericardium has two layers, which have a “potential space” between them. Normally there are only 10 to 15 milliliters of fluid in this space, lubric…
Sep 02
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Q: Here’s an ECG case of a Dallas, Texas resident. A 68-year-old man was having lunch at Patrizio’s in Highland Park Village (www.hpvillage.com) with his wife and two granddaughters. They’d made a day of it, stopping at the Children’s Aquarium at Fair Park (www.childrensaquariumfairpark)  in the morning, with plans to visit American Girl at the Galleria (www.galleriadallas.com) after lunch, when Mr. X suddenly became short of breath and diaphoretic. An alert waiter called 911 and Mr. X was taken by ambulanc…
Aug 31
Someone asked this question the other day in a thread, and I had planned to write a blog post about it – but there really isn’t much to say. At some point, life ends for all of us. When you are resuscitating someone from a terminal rhythm, you should be aware that the rhythm progression is often somewhere along a continuum from ventricular tachycardia to ventricular fibrillation to PEA and asystole. At some point, you will have tried all of the interventions available to you, and the patient will have been …
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