Help with Strips

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I am not very knowledgable when it comes to understanding EKG strips but I hope someone can help. I was listening to my scanner at home today and I heard one of the EMS squads en route to the hospital with a man that had been at a MD's office and said apparently he was having an MI. It said on the monitor he was showing tombstones. What does that mean? I just knew it didn't sound good. Anyone have a clue?:rolleyes:

Had a patient discharged, D/C instructions given - IV out - telemetry off - waiting on family to transport, started saying "Oh my God I'm gonna die" "help me, help me" sent MONA in (Morphine,oxygen,nitro, OK not the ASA) was already on ASA. By the time (short time) she got to ICU she had "tombstone T waves" was a NSR on the floor prior to transfer. Patient saw Jesus ( I hope) two days later.

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Specializes in ER.

ecg08.f3.gif

This is what tombstones would look like on the EKG...usually seen in anterior wall MI's...Also, you can sometimes see it after you give thrombolytics...it's a reperfusion injury..usually goes away in a couple of seconds to minutes during reperfusion...

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RULE #1 treat the patient not the monitor !!!!!!!!!!

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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Amen, bob!! :D

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Specializes in CCU/CVU/ICU.
ecg08.f3.gif

Also, you can sometimes see it after you give thrombolytics...it's a reperfusion injury.....

When discussing reperfusion patterns w/12-leads (or standard tele), you're most likely to see PVC's and other ectopic (usually ventricular) beats, rhythms, etc...rather than severe st-elevation.

And this ugly elevation can be seen anywhere the heart is injured..not just anterior...

Good picture you've posted...

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Specializes in ER.
When discussing reperfusion patterns w/12-leads (or standard tele), you're most likely to see PVC's and other ectopic (usually ventricular) beats, rhythms, etc...rather than severe st-elevation.

And this ugly elevation can be seen anywhere the heart is injured..not just anterior...

Good picture you've posted...

You are right about the PVC's and other ectopic beats...however you can also very well see severe st-elevation with reperfusion. It actually happens quite frequently...It is usually very transient however. You also can see elevation any where the heart is injured, however the classic "tombstone" appearing elevations are most frequently seen in the anterior leads.

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