ECG education

An uncommon cause of a common condition

ECG education

An uncommon cause of a common condition

Vivienne Miller

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Abstract

Articles in this section are inspired by, but not based on, real cases to illustrate the importance of knowledge about ECGs in relation to clinical situations in general practice. Management is not discussed in detail.

Key Points

  • Acute coronary syndromes comprise unstable angina, ST-elevation myocardial infarction (STEMI) and non-STEMI; management of patients with these conditions differs in the acute phase but is similar after hospital discharge.
  • ST-elevation or anterior ST depression on an ECG should be considered to signify a STEMI until proven otherwise.
  • A normal ECG does not exclude non-STEMI; serial ECGs and troponin measurements are advised.
  • Defibrillation requires some form of cardiac electrical activity to have a chance of success.
  • Only one medication is recommended in Australia for resuscitation in asystole: intravenous or intraosseus adrenaline (epinephrine) 10mcg/kg, maximum 1mg, followed by a fluid push if available.
  • Atropine (0.03 mg/kg) is no longer recommended for management of asystole but may be used if a bradycardic pulseless rhythm is obtained.