David Didlake

Acute Care Nurse Practitioner. Firefighter / Paramedic (Ret).

[David Didlake @DidlakeDW]

@PPodrid Appears to be subtle AV decrement between QRS 1 and 2, which may have progressed to otherwise typical Wenckebach. But this is interrupted by trigeminal non-conducted PAC’s.

[David Didlake @DidlakeDW]

@VintageRockN_85 Steve Howe (Yes)

[David Didlake @DidlakeDW]

@BobbyDukeArts The official White House position

[David Didlake @DidlakeDW]

@PrecordialSwirl @ECGWeekly Dear colleague, i am no wizard. Just a forever student of ECG’s. These are my “go to” books, if you haven’t heard of them.

[David Didlake @DidlakeDW]

@OnlyEcg1 Bigeminal non-conducted PAC’s

[David Didlake @DidlakeDW]

@The_Iron_grey @ecgandrhythmRoe @Ecgloverr @ecgchallenge @Ahmedata7777 @DrAkhilX @Frances98392343 @nihar_nayak2 @outrageeouss Can i share this on @EMS12Lead facebook page?

[David Didlake @DidlakeDW]

@RobertHermanMD @smithECGBlog @PendellM @willyhfrick @EkgHacks @ecgrhythms @EM_RESUS @TheEKGGuy This is great @RobertHermanMD! My teenage daughter, an OMI padawan (mostly a consequence of proximity to her dad, lol) was watching this episode and sent me a text “Dad, the show is doing posterior leads.”

[David Didlake @DidlakeDW]

@Jagdish26039718 @ecgandrhythmRoe @ecgrhythms @The_Nanashi_O @JoySanyal74 Eesh, completed infarct with LV dysfunction. Some of the T waves still seem pretty deep, so maybe salvageable myocardium remains.

[David Didlake @DidlakeDW]

@Frances98392343 I think we’re talking about the same inscription, just different leads

[David Didlake @DidlakeDW]

@Frances98392343 Actually, this might be the key. Gives the appearance of PAC initiation, so perhaps an EAT with an unusually short PRi. Conversely, a Junctional origin where the retrograde P precedes the QRS.

[David Didlake @DidlakeDW]

@Frances98392343 Seems like a PVC triggering an atypical AVNRT

[David Didlake @DidlakeDW]

@Frances98392343 Fusion, i think

[David Didlake @DidlakeDW]

@willyhfrick Either way, trying to better understand why the morphology is unchanged between native and paced complexes. Very thought provoking case!

[David Didlake @DidlakeDW]

@willyhfrick Could this be some kind of exit block in the tissue with intimate proximity to the TVP wire?

[David Didlake @DidlakeDW]

@willyhfrick I think i just made a rookie mistake on the original markings. The “wave” of perfusion on SpO2 pleth should come after contractility on Tele. So, red notes the paired QRS/Pleth, and blue is where that synchrony fails.

[David Didlake @DidlakeDW]

@KostekMilan @ALFIEEP1 @Ecgloverr @SergioPinski @adribaran @ProfDConnelly @DaveRichley @Mazdamot04 @javadm20 @ChristianHeeger @jeffrey_vinocur @willyhfrick @DrRoderickTung @IsaParam @Arron_Pearce_ Agreed, neither are leisurely reading. Almost exhaustive, rather, and requires multiple reviews to digest.

[David Didlake @DidlakeDW]

@KostekMilan @ALFIEEP1 @Ecgloverr @SergioPinski @adribaran @ProfDConnelly @DaveRichley @Mazdamot04 @javadm20 @ChristianHeeger @jeffrey_vinocur @willyhfrick @DrRoderickTung @IsaParam @Arron_Pearce_ My own favorites :)

[David Didlake @DidlakeDW]

@EcgOxford @akneton @yolyabreuh @UlhasDr @ecgrhythms @IhabFathiSulima @DrPharmDMDTh @Vadeboncoeur_Al @smithECGBlog @EM_RESUS @estudiomedicina @OrlandoRPN @fxgodzeuss @ResusMed @TrRja @NaokiThukishima @ecgandrhythmRoe Seems like coarse AF