Emergency Medicine Cases

ECG Cases 58 – ACLS Dysrhythmia Pitfalls, Part 1: Unstable Bradycardia – BRADI mnemonic

In this ECG Cases blog with Dr. Jesse McLaren we go through exemplary cases and look for reversible causes of secondary BRADIcardias, some of which can be identified on 12-lead ECG: BRASH/hyperkalemia requiring empiric calcium, Reduced vitals requiring support (eg hypoxia, hypothermia), Acute coronary occlusion (especially inferior/posterior) requiring reperfusion, Drugs requiring withholding or reversal, and ICH requiring surgery or Infection (eg lyme) requiring antibiotics...

By Jesse McLaren|2025-10-28T12:53:12-04:00October 28th, 2025|Categories: Cardiology, ECG Cases, EM Cases, Emergency Medicine|Tags: ACLS, bradycardia, Dr. Jesse McLaren, ECG cases, ECG interpretation|0 Comments

ECG Cases 54 The Art of Occlusion MI: Scale and Proportionality

On this month's ECG Cases, Dr. Jesse McLaren explains how STEMI criteria can be false positive with large scale QRS and proportional ST elevation, or false negative with low/normal scale QRS and disproportionate ST elevation and hyperacute T waves, and that rules for subtle occlusion using proportionality can help differentiate LBBB with or without Occlusion MI, or LV aneurysm vs anterior STEMI with Q waves... Please consider a donation to EM Cases to ensure continued Free Open Access Medical Education here: https://emergencymedicinecases.com/donation/

By Jesse McLaren|2025-02-17T12:26:20-05:00February 17th, 2025|Categories: Cardiology, ECG Cases, EM Cases, Emergency Medicine|Tags: Dr. Jesse McLaren, early repolarization, ECG, ECG interpretation, LBBB, LVH, occlusion MI, STEMI|0 Comments

ECG Cases 53 – The Art of Occlusion MI, part 1: Mirror Image

In this month's ECG Cases Jesse McLaren takes us through 6 cases highlighting important mirror concepts in ECG interpretation including: which leads are reciprocal to each other, how to identify which is the main ST/T change and which is the mirror, reciprocal changes highlighting subtle inferior, lateral and posterior OMI, ST elevation in aVR as a mirror to widespread ST depression and more...

By Jesse McLaren|2025-01-28T11:17:51-05:00December 3rd, 2024|Categories: Cardiology, ECG Cases, EM Cases|Tags: Dr. Jesse McLaren, ECG, ECG interpretation, mirror image, occlusion MI, reciprocal change, STEMI|4 Comments

EM Quick Hits 59 Traumatic Coronary Artery Dissection, Proper Use of Insulin, Mesenteric Ischemia, Exercise Associated Hyponatremia, AI for OMI

On this month's EM Quick Hits podcast: Ian Chernoff on the often elusive diagnosis of traumatic coronary artery dissection, Anand Swaminathan on proper use of insulin in DKA and in hyperkalemia, Brit Long and Hans Rosenberg on mesenteric ischemia pearls and pitfalls in diagnosis and management, Dave Jerome on recognition and management exercise-associated hyponatremia and heat illness and Jesse McLaren on the Queen of Hearts AI model in helping identify occlusion MI on ECG... Help Support EM Cases by Giving a Donation here: https://emergencymedicinecases.com/donation/

By Anton Helman|2024-09-27T20:16:00-04:00September 10th, 2024|Categories: Cardiology, EM Cases, EM Quick Hits, Emergency Medicine, Medical Specialty, Trauma|Tags: AI, DKA, EAH, ECG interpretation, Exercise Associated Hyponatremia, hypokalemia, hyponatremia, Mesenteric Ischemia, OMI, SCAD|0 Comments

ECG Cases 51 – Artifact and Lead Misplacement

ECG artifact and lead reversal can mimic tachy-arrhythmia, infarct or Brugada. Learn how to identify these errors to prevent misdiagnosis on this month's ECG Cases with Dr. Jesse McLaren... Help Support EM Cases by Giving a Donation here: https://emergencymedicinecases.com/donation/

By Jesse McLaren|2025-12-14T11:35:17-05:00August 19th, 2024|Categories: Cardiology, ECG Cases, EM Cases|Tags: Dr. Jesse McLaren, ECG, ECG artifact, ECG interpretation, lead misplacement|2 Comments

EM Quick Hits 57 – HIV Diagnosis, Failed Paradigm of STEMI Criteria, Poisoned Patient Airway Management, Spontaneous Bacterial Peritonitis, DIY Investments

In this month's EM Quick Hits podcast: Megan Landes on the importance of diagnosing HIV in the ED, Jesse McLaren on the failed paradigm of STEMI criteria and ECG tips to identify acute coronary occlusion, Anand Swaminathan on evidence for non-invasive airway management in the poisoned patient, Brit Long and Hans Rosenberg on the identification, workup and management of spontaneous bacterial peritonitis, Matt Poyner on the most lucrative side-gig, DIY investing. To support EM Cases, please consider a donation here: https://emergencymedicinecases.com/donation/

By Shaila Gunn|2024-06-18T13:10:16-04:00June 18th, 2024|Categories: Cardiology, EM Cases, EM Quick Hits, Emergency Medicine, Gastroenterology, Medical Specialty, Resuscitation, Special Populations, Toxicology|Tags: ascites, cirrhosis, ECG interpretation, hiv, intubation, occlusion MI, paracentesis, spontaneous bacterial peritonitis, STEMI, toxicology|4 Comments

ECG Cases 50 – STEMI: A Failed Paradigm, Enter Occlusion MI

Dr. Jesse McLaren illustrates the paradigm shift from STEMI to Occlusion MI (OMI) through 9 cases, and drives home the points that if there is STEMI criteria, consider false positives (eg. secondary and proportional to LVH or BER); if there is no STEMI criteria, consider false negatives and look for other signs of occlusion (eg. acute Q waves or loss of R waves, hyperacute T waves, or reciprocal STD/TWI) and if the ECG is nondiagnostic, consider other OMI signs including clinical (refractory ischemia, hemodynamic/electrical instability) and POCUS (new regional wall motion abnormalities).

By Jesse McLaren|2024-06-18T12:07:45-04:00June 18th, 2024|Categories: Cardiology, ECG Cases, EM Cases, Emergency Medicine|Tags: Dr. Jesse McLaren, ECG, ECG interpretation, occlusion MI, STEMI|0 Comments

ECG Cases 49 – ECG and POCUS for Dyspnea and Chest Pain

In this ECG Cases blog, Jesse McLaren and Rajiv Thavanathan explore how ECG and POCUS complement each other for patients presenting to the emergency department with shortness of breath or chest pain. They explain complementary diagnostic insights into pericardial effusion and cardiac tamponade, occlusion MI and RV strain...

By Jesse McLaren|2024-04-02T12:12:27-04:00April 2nd, 2024|Categories: Cardiology, ECG Cases, EM Cases, Emergency Medicine, POCUS Cases|Tags: CHF, ECG, ECG interpretation, occlusion MI, pericardial effusion, POCUS, pulmonary embolism, RV strain, STEMI|0 Comments

ECG Cases 48 – ECG Interpretation in Cardiac Arrest

In this month's ECG Cases blog Dr. Jesse McLaren reviews interpretation of the pre-arrest ECG: identifying high risk ECGs requiring empiric treatment like calcium for hyperkalemia, magnesium for long QT, or reperfusion for Occlusion MI; the intra-arrest ECG: identifying pseudo-PEA; and post-arrest ECG: the importance of serial ECGs to reduce false positive STEMI, role of POCUS to help with the differential of diffuse ST depression with reciprocal ST elevation in aVR, and identifying signs of Occlusion MI/ false negative STEMI...

By Jesse McLaren|2024-02-13T11:44:22-05:00February 13th, 2024|Categories: Cardiology, ECG Cases, EM Cases, Emergency Medicine|Tags: cardiac arrest, ECG, ECG interpretation, hyperkalemia, occlusion MI, PE, STEMI, tamponade|0 Comments

EM Quick Hits 54 Button Battery Ingestion, C. difficile, ECG in Tox, Bed Bugs, Fibrinogen in Trauma, Cold Air for Croup

Olivia Ostrow on the management of button battery ingestions, Brit Long on C difficile infection, Jesse McLaren on an approach to ECG's in the tox patient, Joe Mullally on the identification and treatment of bed bug bites, Andrew Petrosoniak on fibrinogen replacement in bleeding trauma patients, Justin Morganstern on Cold Air for Croup... https://emergencymedicinecases.com/donation/

By Shaila Gunn|2025-05-02T10:41:50-04:00January 23rd, 2024|Categories: Cardiology, EM Cases, EM Quick Hits, Emergency Medicine, Gastroenterology, Medical Specialty, Pediatrics, Toxicology, Trauma|Tags: bed bugs, button battery, c.difficle, croup, ECG interpretation, fibrinogen, toxicology, trauma|0 Comments