ResusX:Podcast Post-Arrest ECGs That You Gotta Know
20 snips
Feb 4, 2025 
Dr. Amal Mattu, a leading expert in acute care medicine and cardiology from the University of Maryland, shares invaluable insights on post-arrest ECG interpretation. He emphasizes the dangers of misreading early ECGs, particularly the risks associated with VTach mimics. Listeners will learn when to repeat ECGs and when to refer patients for catheterization. Dr. Mattu also discusses life-threatening conditions like hyperkalemia and sodium channel toxicity that can look like VTach. His real-case examples make the discussion both practical and engaging.
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Post-Arrest STEMI
- Look for ST elevation on post-arrest ECGs to guide treatment.
- Send patients with ST elevation (STEMI) immediately for catheterization.
Non-STEMI Management
- For patients without ST elevation (NSTE-ACS), consider medical management initially.
- Delay catheterization for a day or two unless there's evidence of ST elevation MI on the 12-lead ECG.
Repeat ECG
- Post-arrest ECGs can overestimate ischemia, especially in the first 8-20 minutes.
- Repeat the ECG after about 20 minutes to get a clearer picture, especially before deciding on immediate catheterization.