Modified Sgarbossa Criteria

More sensitive for detecting OMI in paced rhythms.

https://journalfeed.org/article-a-day/2021/modified-sgarbossa-criteria-for-ventricular-paced-rhythms

OHCA Outcome prediction score: MIRACLE 2

EKG Random tips

Check first for lead placement: AVR and AVL should be mirror images
Limb leads: (a) check aVR for upside down P, QRS and T waves, (b) aVL and aVR should generally be mirror images.
Chest leads: look for RS pattern in V1 – changing progressively to QR pattern in V6.

Reference: https://litfl.com/ecg-rule-of-fours/

EKG Basic Interpretation Video

EKG = Hypokalemia

Flattening of T wave and appearance of U wave directly after
V2 and V3 usually
Can appear as prolonged QT due to U wave, treat similarly
NOT ACS/Ischemia.
“reverse wellens or Nikelkam twave”

Info from Amal Mattu EEM 2019: Hypokalemia: You thought you knew how to recognize it

Elevated BP

Immediately put in their ED diagnosis list “Elevated blood pressure without history of hypertension.” Populate their discharge instructions with the following phrase…

Your blood pressure was noted to be elevated on today’s evaluation. This does not mean that you have chronic high blood pressure as it could be related to the events which led to your emergency department visit. However, I recommend that you check your blood pressure a few times a day, keep a record of the readings, and take this log to your primary care provider on the next appointment.** At that time, you and your primary care provider can discuss any further action that needs to be taken.

ECG in Syncope

ACS/MI
Dysrhythmias
HOCM
BRUGADA
WPW
Prolonged QT

Atrial Fibrillation

I’ll probably need to add to this and make it a better graphic eventually.

P – Pulmonary (PE, COPD)
I – Iatrogenic (endoscopy, central line, etc), Infectious, Infarction (MI), Idiopathic
R – Rheumatic Heart Dx (MR or MS)
A – Anemia
T – Toxins, Thyroid
E – Electrolytes, Endocarditis, Ethanol
S – Sepsis, Stimulants