Key Points:
- Critical ECG patterns represent time-sensitive, life-threatening cardiac or systemic conditions that demand immediate recognition to prevent death or irreversible organ injury. These are the “can’t-miss” ECGs. Use this hub as a front door to the highest-risk ECG patterns and link quickly to STAT posts that tell you what to do next.
- Purpose: Rapid recognition plus immediate bedside guidance for the most lethal ECG presentations encountered in emergency, critical care, and prehospital settings.
- Use-cases: Triage ECGs, EMS ECGs, “looks bad” monitor rhythms, post-ROSC ECGs, and any unstable patient where skillful ECG interpretation impacts the next few minutes of care.
- Workflow: Identify a critical ECG pattern → assess stability → start life-saving actions → open the linked relevant STAT post for nuance and pitfalls.
How to Use This Hub:
The Life Savers hub is your launchpad for time-sensitive ECG patterns. Each item below links to a focused STAT reference that covers:
- Pattern recognition in real-world messy ECGs
- “What to next” actions
- High-risk mimics and common traps
- Disposition and team activation pearls
How to use this hub (fast):
- Stability first: hypotension, altered mental status, ongoing chest pain, pulmonary edema, shock, severe hypoxia, or electrical instability.
- Name the danger category: arrest rhythm, unstable tachy or brady, occlusion pattern, obstructive process, tox or metabolic pattern.
- Act, then refine: start the correct immediate pathway, then click into the STAT page to avoid classic errors.
Cardiac Arrest & Electrical Instability:
Unstable Rhythms:
Ischemic & Structural Life Threats:
Tox & Metabolic Emergencies:
Systemic & Neurologic Emergencies:
More About STAT ECGs:
Key Clinical Pearls:
-
Time-sensitive patterns deserve time-sensitive labels. “No STEMI” is not the same as “not dangerous.” If the ECG is abnormal and the patient is sick, treat the situation, not the label.
-
Wide-complex tachycardia: default to VT until proven otherwise, but actively consider VT mimics when the clinical story is off.
-
Irregular wide and fast: think pre-excited AF until proven otherwise. Avoid AV nodal blockers.
-
Severe bradycardia with instability: treat per ACLS, but do not miss hyperkalemia or drug effect as the reversible cause.
-
Subtle OMI exists. Small ST elevation with reciprocal depression, hyperacute T waves, posterior patterns, de Winter, and occlusion equivalents belong in the “act now” lane even if they fail classic millimeter thresholds.
-
Serial ECGs save lives. Repeat in 10 to 15 minutes when symptoms persist or the story is high-risk. Dynamic changes beats a single ECG snapshot.
Related content & recommendations:
