ECG in Emergency Decision Making

ISBN-10: 1416002596
ISBN-13: 9781416002598
Edition: 2nd 2006
List price: $65.95 Buy it from $59.47
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Description: Offering step-by-step instructions, this text describes how to use 12-lead electrocardiograms (ECGs) to make rapid and informed decisions in emergencies. It shows how to recognize the underlying mechanism of a cardiac emergency, its significance,  More...

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Book details

List price: $65.95
Edition: 2nd
Copyright year: 2006
Publisher: Elsevier - Health Sciences Division
Publication date: 9/8/2005
Binding: Paperback
Pages: 304
Size: 7.75" wide x 9.75" long x 0.75" tall
Weight: 1.386
Language: English

Offering step-by-step instructions, this text describes how to use 12-lead electrocardiograms (ECGs) to make rapid and informed decisions in emergencies. It shows how to recognize the underlying mechanism of a cardiac emergency, its significance, and the best treatment. A brief outline of these steps is followed by complete, in-depth coverage. Summary boxes at the beginning of chapters give a step-by-step guide of emergency approaches Clear, consistent writing and organization Reflects the latest American Heart Association guidelines Perforated decision making cards at the end of the book (various emergency situations) can be used for quick access in the clinical setting Established, well-respected authors provide cutting-edge info that practitioners can trust Reviewed by a consulting board of nationally recognized experts in the specialty area of ECG Information on using the ST deviation vector in acute myocardial infarction to localize the site of occlusion in the coronary artery and thereby the site and size of the area at risk. How to risk stratify and treat patients with acute coronary syndromes showing ST segment depression. Noninvasive measures to determine the site of atrioventricular block. A guide to prehospital screening for patients with chest pain. The ECG features of myocardial infarction in patients with an acute myocardial infarction AND a left bundle branch block. New information on monogenic diseases leading to cardiac arrhythmias. Perforated decision-making cards for quick access in the emergency setting.

The ECG in Acute ST Segment Elevation MI
ST Segment Elevation MI
The Importance of ST Segment Deviation
ST Segment Deviation Score
ST Segment Deviation Vector
Determining the Site of Occlusion in the Coronary Artery
Inferoposterior ST Segment Elevation MI
Isolated RV ST Segment Elevation MI
Anterior ST Segment Elevation MI
Limitations of the ST Deviation Vector Approach in MI Diagnosis
Risk Stratification
Primary Percutaneous Coronary Intervention Versus Thrombolytic Therapy
Recognition of the High-Risk Patient
Conduction Disturbances in Acute MI
Diagnosis of MI During Abnormal Ventricular Activation
ECG Signs of Reperfusion
ST Segment Changes
T-Wave Changes
Ventricular Arrhythmias
Supraventricular Arrhythmias
Differential Diagnosis
Acute Pulmonary Embolism
Acute Pericarditis
Aortic Dissection
Myocarditis
Pancreatitis and Cholecystitis
Transient LV Apical Ballooning (Takotsubo Cardiomyopathy)
Treatment of ST Segment Elevation MI
Management Relative to Time Interval from Pain to Medical Attention
ECG Recognition of Non-ST Elevation MI and Unstable Angina
An Early Invasive Versus A Conservative (Selective Invasive) Approach in Unstable Coronary Artery Disease
The Value of the ECG in Non-ST Segment Elevation MI and Unstable Angina
Conclusion
Bradyarrhythmias
SA Conduction Abnormalities
Mechanism
Causes
Diagnosis
Type II Second-Degree SA Block (SA Mobitz II)
Two-To-One SA Block
Complete SA Block and Sinus Arrest
Sick Sinus Syndrome
AV Conduction Disturbances
Classification of AV Block
Noninvasive Methods for Determining Site of AV Block
His Bundle Electrogram
Prolonged PR Interval
Second-Degree AV Block
Type I AV Block (AV Wenckebach)
Type II (Mobitz II) AV Block
Two-To-One AV Block
Complete AV Block (Third-Degree AV Block)
Paroxysmal AV Block
Narrow QRS Tachycardia
Causes of Narrow QRS Tachycardia
Three Most Common Types of Regular SVT
Systematic Approach
Physical Examination During SVT
Different Types of SVT
Atrial Tachycardia
Atrial Flutter
Atrial Fibrillation
AV Nodal Reentry Tachycardia
Wolff-Parkinson-White Syndrome
Mechanism of Preexcitation
Concealed Accessory Pathway
Circus Movement Tachycardia
Orthodromic Circus Movement Tachycardia with a Rapidly Conducting Accessory Pathway
Orthodromic Circus Movement Tachycardia with a Slowly Conducting Accessory Pathway
Systematic Approach to the Patient with a Narrow QRS Tachycardia
Is AV Block Present?
Is QRS Alternans Present?
Where is the P Wave Relative to the QRS?
What is the Polarity (AXIS) of the P Wave?
Aberrant Ventricular Conduction, a Helpful Clue
Systematic Approach to Treatment of Regular SVT
Vagal Stimulation
Types of Vagal Maneuvers
Carotid Sinus Massage
How to Perform Carotid Sinus Massage
Effect of Carotid Sinus Massage on SVT
Emergency Management of Atrial Fibrillation
Atrial Fibrillation Present Less than 48 Hours
Recent Onset Atrial Fibrillation: Hemodynamically Unstable
Atrial Fibrillation Present More than 48 Hours: Hemodynamically Stable
Atrial Fibrillation Present More than 48 Hours: Hemodynamically Unstable
Wide QRS Tachycardia
Causes
Physical Evaluation for AV Dissociation
ECG Findings of Value in Differentiating Causes of a Wide QRS Tachycardia
AV Dissociation
Configurational Characteristics of the QRS Complex
RBBB-Shaped QRS Complex
LBBB-Shaped QRS Complex
Other Diagnostic Clues
Three Signs and Symptoms that Cannot Be Used in the Differential Diagnosis of Broad QRS Tachycardia
Wide QRS Tachycardias in Patients with an Accessory AV Pathway
Regular Tachycardias
Irregular Wide QRS Tachycardia: Atrial Fibrillation with Conduction over an Accessory Pathway
Emergency Treatment of the Wide QRS Tachycardia
When in Doubt
When VT is the Diagnosis
When SVT is the Diagnosis
Superiority of Procainamide over Lidocaine in VT Outside an Episode of Acute Cardiac Ischemia
Systematic Approach to Wide QRS Tachycardia
Follow-Up Care
Digitalis-Induced Emergencies
Actions
Mechanism of Digitalis Toxicity
Conditions that May Promote Digitalis Toxic Arrhythmias
Suppressants of Triggered Activity
St-T Segment Changes During Digitalis Use
Typical Features of Digitalis Arrhythmias
Slow Rhythms
Rapid Rhythms
Ventricular Bigeminy
Atrial Fibrillation with Digitalis Toxicity
Atrial Flutter
Symptoms of Digitalis Intoxication
Mortality Rate in Undiagnosed Digitalis Toxicity
Factors Affecting Dosage Requirements in Patients Taking Digitalis
Treatment of Digitalis Arrhythmias
Dangers of Pacing and Carotid Sinus Massage
A Systematic Evaluation of Patients Taking Digitalis
Drug-Induced Arrhythmic Emergencies
Mechanisms of Drug-Induced Arrhythmias
Afterdepolarizations
QT Prolongation
Torsades De Pointes
Reentry
Class IC Drug-Related Emergencies
Drug-Induced Bradycardia
Potassium-Related Emergencies
Potassium
Hyperkalemia
Hypokalemia
ECG Recognition of Acute Pulmonary Embolism
Value of the ECG
Value of the Echocardiogram
ECG Findings During the Acute Phase
ECG During the Subacute Phase
ECG During the Chronic Phase
Pathophysiology
Signs and Symptoms
Physical Findings
Incidence
Differential Diagnosis
Emergency Treatment
Prevention
Hypothermia
Hypothermia
Hypothermia Not Caused by Exposure to Cold
Emergency Decisions in Monogenic Arrhythmic Diseases
Hypertrophic Cardiomyopathy
ECG Findings
Differentiation Between Hypertrophic Cardiomyopathy and Athlete's Heart Syndrome
Risk Factors for Sudden Death
Emergency Response
Long-Term Management
Arrhythmogenic RV Dysplasia/Cardiomyopathy
ECG Recognition
The ECG During Nonsustained and Sustained VT
Differentiating Arrhythmogenic RV Dysplasia/Cardiomyopathy VT from Idiopathic VT
Incidence
Diagnosis
Symptoms
Prognosis
Cause
Management
Congenital Long QT Syndrome
Incidence
ECG Signs
Torsades De Pointes
Risk Factors: Age and Sex
Clinical Characteristics
Emergency Response to Torsades De Pointes in Congenital Long QT Syndrome
Long-Term Management
Importance of Counseling
Summary of Inherited Lqts
Brugada Syndrome
ECG Diagnosis
Unmasking Concealed and Intermittent Forms
Pathophysiologic Characteristics
Incidence
Risk Stratification
Treatment
Summary of Brugada Syndrome
Catecholaminergic Polymorphic VT
Management
Short QT Syndrome
Pacemaker and Defibrillator Emergencies
Pacing Emergencies
Introduction
Failure to Capture or Sense
Pacing Failure
Pacemaker Syndrome
Pacemaker-Mediated Tachycardia
Myocardial Perforation and Tamponade
Managing Occasional Atrial Tachycardias in Patients with Pacemakers
Burst-Type Antitachycardia Pacing
Thrombosis and Pulmonary Embolism
Infection or Erosion of the Pulse Generator
Electromyographic Inhibition
Arrhythmias During Pacemaker Insertion
The Implantable Cardioverter-Defibrillator
In Case of Emergency
Electrical Storm
Treatment
Psychosocial Considerations
Prehospital Cardiac Emergencies
Reasons for Delay
Patient and Family Education
Training of the Emergency Response Team
Inhospital Response
Prehospital Assessment of High-Risk Patients with Chest Pain
History
Physical Examination
The ECG
Usefulness of Lead V[subscript 4]R in Acute Inferior MI
Significance of Bundle Branch Block in Acute Anterior MI
Thrombolytic Therapy
Initiation of Prehospital Thrombolytic Policy
Evaluation of the Patient for Thrombolytic Therapy in the Field
When Reperfusion Therapy is Indicated
Response at the Base Hospital
Causes for Delay
Candidates for Thrombolysis
Absolute Contraindications for Thrombolysis
Relatively Major Contraindications (Individual Evaluation of Risk Versus Benefit)
Relatively Minor Contraindications
Unstable Angina with ST Segment Depression or Negative T Waves
Recognition of Critical Proximal Lad Coronary Artery Stenosis
Recognition of Left Main Stem and Three-Vessel Disease
Conscious Patient with a Tachycardia
Narrow QRS Tachycardia
Broad QRS Tachycardia
Treatment
Unconscious Patient
Unconscious Patient in Tachycardia
Unconscious Patient in Bradycardia
Emergency Cardioversion
Energy Settings for Defibrillation and Cardioversion of Unconscious Patients
Automatic External Defibrillator
Precordial Thump
Determining the Axis of the ECG Components
Electrical Treatment of Arrhythmias and the Automated External Defibrillator in Out-of-Hospital Resuscitation
Emergency Drugs
Mechanisms of Aberrant Ventricular Conduction
Perforated Decision-Making Cards

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