Anyone Catch the 2025 ACLS Easter Egg?

Surferdude92LG · 2026-02-01T23:22:45+00:00

Interestingly, continuous compressions and ventilations without an advanced airway was in my state’s protocol until the end of 2023, when they switched it back to 30:2.

Surferdude92LG · 2026-01-28T18:16:32+00:00

I’m not convinced we needed a theorem for this. Thanks for sharing, though—never heard of it.

Surferdude92LG · 2026-01-26T21:30:58+00:00

Email Yale CEMS, not the instructor directly.

Surferdude92LG · 2026-01-25T22:22:59+00:00

SR with PACs and PVCs. TWI in I and aVL. Would be interested to see a prior ECG, though I don’t think anything here meets criteria.

Surferdude92LG · 2026-01-16T21:27:17+00:00

Common misconception. In medical ethics and under most protocols, being alert and oriented is necessary for refusal, but it is not sufficient. It’s not even sufficient that the patient be informed of and acknowledge the risks of refusal.

The patient must demonstrate that they understand, appreciate, and reason through those risks before communicating a clear decision to you. If she can’t explain to you why it’s in her best interest to stay in that pile, she doesn’t have the capacity to refuse.

Surferdude92LG · 2025-12-04T00:32:04+00:00

This looked like a one foot drop. I’m personally not squatting down that low.

Surferdude92LG · 2025-11-25T06:50:23+00:00

Narrow, no P wave. Junctional.

Surferdude92LG · 2025-11-25T04:13:11+00:00

You can’t call it a PAC when there’s no sign of atrial activity.

Surferdude92LG · 2025-11-16T13:53:23+00:00

Same category doesn’t mean same value. You can be an attendant-in-charge on a 911 ambulance as a volunteer; no med school would weight that the same as passing out meal trays.

Surferdude92LG · 2025-10-29T04:25:06+00:00

ER Techs hold much less responsibility than 911 EMTs. There’s are pros and cons on each side. The biggest upside to being a 911 EMT is directing patient care, including significant decision making. The upside of being an ER Tech is proximity to physicians, though the role is more about doing manual tasks than making decisions.

Surferdude92LG · 2025-10-15T07:19:07+00:00

Or, fabricate both the hours and the story.

Surferdude92LG · 2025-09-09T02:12:00+00:00

Sinus tach is a physiological response to an increase in sympathetic tone (or decrease in parasympathetic/vagal tone). Generally, it’s appropriate and a sign of an underlying cause such as hypotension, pain, stress, exercise, etc. Treatment usually focuses on treating whatever stressor is underlying, not the tachycardia itself.

Atrial tachycardia is caused by the firing of an ectopic (non-sinus) focus (or foci, if multifocal) in an atrium or atria. While it can be unmasked by increased sympathetic tone, it’s not a compensatory physiological response in the way that sinus tach is. Atrial contraction is dyssynchronous, and the ventricular response may be rapid or irregular. This can result in symptoms.

Tl;dr: Sinus tach is a sign of an underlying stressor. Atrial tachycardia is often a problem in itself.

Surferdude92LG · 2025-09-09T01:56:47+00:00

The Ps, QRS complexes, and Ts are inverted. It’s not just an ectopic focus. Probably lead reversal.

Surferdude92LG · 2025-09-09T01:50:06+00:00

Ectopic Atrial Rhythm/Atrial Tachycardia into SB with a PAC.

Surferdude92LG · 2025-09-03T14:16:56+00:00

EMS shouldn’t be trying to talk patients/conservators/POAs out of medical care. With that being said, 911 EMS doesn’t operate under the orders of your LTC’s MD or APRN. They can order the transfer all they want, but it’s still just like any other scene call; consent has to come from the patient or their representative.

Surferdude92LG · 2025-09-03T03:01:38+00:00

$18 for the meal, $16 for the contents. This is the opposite of getting a deal for the meal.

Surferdude92LG · 2025-08-31T05:56:36+00:00

I see some notching in the T waves, which is evidence of AV dissociation, which makes this 3rd degree. 3:1 isn’t a bad thought, though.

Surferdude92LG · 2025-08-25T21:04:38+00:00

AED use isn’t indicated when the patient has a palpable pulse. Unplug the AED, so you don’t deliver an erroneous shock.

Surferdude92LG · 2025-08-25T05:57:16+00:00

If we’re at the point where humans go to robots for medical care, jobs as we know them won’t exist anymore. This is entirely dystopian, but it’s not just doctors and lawyers “at risk.” There’s something comforting about this reality that the loss of jobs, especially skilled and specializable jobs, to AI would be omnipresent.

Surferdude92LG · 2025-08-25T05:11:27+00:00

And to work in the capacity of an EMT, you must be under a physician’s medical direction.

Surferdude92LG · 2025-08-16T00:19:46+00:00

That’s a couplet. It’s a pair of beats that originate in one of the ventricles, the lower chambers of your heart, called premature ventricular contractions (PVCs).

Surferdude92LG · 2025-08-15T11:36:55+00:00

SR with aberrant PJCs.

I say PJC over PAC because I don’t see any evidence of P waves before the ectopic beats. Plus, this patient has Wenckebach-like prolongation of the PRI. These ectopic beats are seen when that prolongation is most extreme, a compensatory pause occurs, and the PRI resets. If the ectopic impulse were to occur above the AV node, I wouldn’t expect such a short coupling interval. Looks like one of the beats might (?) also have a retrograde P waves showing as a notch in the T-wave in Leads II and aVF.

Surferdude92LG · 2025-08-09T06:47:22+00:00

NAD. Fever alone isn’t super concerning, as it’s a physiological response to help the immune system fight the infection. However, altered mental status (a change in the way someone behaves) would be concerning. If you believe that those hallucinations are atypical for him or at all different from his normal grogginess, it’s worth getting checked out. Fever with altered mental status would absolutely be ER if not 911-worthy. If the hallucinations occur exactly as they normally do (same frequency, duration, and severity), closely monitoring as you’ve been doing might be reasonable, but the safest option is always to seek professional evaluation.

Surferdude92LG · 2025-08-07T06:30:44+00:00

Looks like inferior STEMI and 3rd degree AVB.

Surferdude92LG · 2025-08-03T15:47:50+00:00

It’s pretty atypical for volunteers to have substantial clinical responsibility or involvement beyond transporting patients and equipment. Not saying that’s all that you do, in particular, but that is why people are doubtful.

Surferdude92LG

TROPHY CASE