Dr. Smith's ECG Blog

Instructive ECGs in Emergency Medicine Clinical Content

Associate Editors:
— Pendell Meyers & Ken Grauer (2018)
— Jesse McLaren & Emre Aslanger (2022)
— Willy Frick (2024) — Sam Ghali (2025)

editors

This ECG is pathognomonic of a life threatening condition, and you must be able to immediately recognize it

What is wrong with this patient who complains of weakness?

PR is 224 ms, QRS 177 ms.  Answer below

Answer: HyperK.  You must be able to recognize this immediately if you take care of patients in EMS or the ED.

3 grams of Calcium gluconate, 100 mEq of bicarbonate, 10 units of regular insulin, and 50g of D50 were given immediately after reading the ECG. 

Then this ECG was recorded:

QRS is now 117 ms

30 minutes later, the lab reported a K of 7.2 mEq/L.

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