Sam Ghali, M.D.

ER Doctor | Resuscitation | Airway | Critical Care | Cardiovascular Emergencies | ECGs | Emergency Radiology | Trauma | #FOAMed | Patient Advocate

[Sam Ghali, M.D. @EM_RESUS]

Here’s a message that was sent to me by an ER resident physician in training who saved a patient’s life half way across the country from me.

When people ask “why teach on social media?”

This is why.

[Sam Ghali, M.D. @EM_RESUS]

@PowerfulMedical This is the patient’s baseline ECG

[Sam Ghali, M.D. @EM_RESUS]

@DrOribaDan @drkeithsiau @rkalyes1 ♥️🙏

[Sam Ghali, M.D. @EM_RESUS]

@ShariqShamimMD @smithECGBlog @realarainmd @mandeep_mayo @AB @DrRajeshG1 @PMcardioApp @DrMarthaGulati @escardio @Pooh_Velagapudi Yes, although we also don’t know what the state of the culprit artery was at the time the ECG was recorded—versus the moment you squirted the dye! :-)

[Sam Ghali, M.D. @EM_RESUS]

@IM_Crit_ Nice. Curious why no ATC on the spontaneous breaths?

[Sam Ghali, M.D. @EM_RESUS]

@jpcostabel Complete AV Block with Left Anterior Fascicular Escape

[Sam Ghali, M.D. @EM_RESUS]

@MSharifpourMD Pure flow destruction!

[Sam Ghali, M.D. @EM_RESUS]

The interesting thing is the incredibly similar ST-T wave morphology in the inferior leads. So do we think this represents reciprocal change (and just happens to have this same appearance) or are they actually de Winter-like T waves also representing transmural ischemia (WrapAround LAD) ? 😄

[Sam Ghali, M.D. @EM_RESUS]

@RobertHermanMD @smithECGBlog @PendellM @ecgandrhythmRoe @ecgrhythms @TheECGMedic @DrparrayMD @DrRazi4 @AndrewACNP1 @tbouthillet LAD possibly even Left Main vulnerable plaque with some degree of reperfusion/flow when this ECG was shot

[Sam Ghali, M.D. @EM_RESUS]

@DrparrayMD @amalmattu @DrRazi4 @PendellM @RobertHermanMD @ShariqShamimMD @ecgandrhythmRoe @EcgsOnly @MirSuhayel @The_Nanashi_O Acute Proximal RCA Occlusion with RV Infarction

[Sam Ghali, M.D. @EM_RESUS]

@TrackYourHeart Looks Underdampened. Do the Square Waveform. Confirm transducer positioning and consider noninvasive site.

[Sam Ghali, M.D. @EM_RESUS]

@4jtweet @HeartOTXHeartMD @YouTube 😂

[Sam Ghali, M.D. @EM_RESUS]

@VRBoombatzMDPhD @HeartOTXHeartMD @YouTube 😂

[Sam Ghali, M.D. @EM_RESUS]

@PulmCrit Sure, as an isolated absolute value—but would you agree Josh that within a steady state of hemoglobin and O2, ScvO2 trends can be helpful?

[Sam Ghali, M.D. @EM_RESUS]

@naleen14 @smithECGBlog @RobertHermanMD @amalmattu Easy RBBB LAD Occlusion. Hope he got prompt reperfusion!

[Sam Ghali, M.D. @EM_RESUS]

@smithECGBlog @PendellM @PMcardioApp Nice case. Was it a WrapAround LAD? (the distal portion of the vessel is cutoff on the angiogram shot!)

[Sam Ghali, M.D. @EM_RESUS]

@DrparrayMD @smithECGBlog @ShariqShamimMD @DrRazi4 @PendellM @The_Nanashi_O @amalmattu @RobertHermanMD @ecgandrhythmRoe A definite victim of STEMI Criteria. Perhaps a victim of sex and young age bias. Improvement in pain with morphine is means nothing and only muddies the water. Hopefully the occluded coronary artery was opened up promptly after she arrested.

[Sam Ghali, M.D. @EM_RESUS]

Check out this recent educational video:

[Sam Ghali, M.D. @EM_RESUS]

It's one of the most insane X-Rays I've ever seen. Here's a video I made breaking it down.

Tell all your friends about this

[Sam Ghali, M.D. @EM_RESUS]

I have nothing to advertise except what I have to teach—follow me if you’re interested in learning about medical emergencies

[Sam Ghali, M.D. @EM_RESUS]

Yes

[Sam Green @SGR5N]

@EM_RESUS Am I the only one who didn’t get the joke here?

[Sam Ghali, M.D. @EM_RESUS]

@SGR5N Yes

[Sam Ghali, M.D. @EM_RESUS]

Hi, ER Doc here.

I don’t know who needs to hear this
but do NOT even think about it.