Bifascicular blocks, BRASH syndrome, and so much more!

Baltimore City EMS Cases with Dr. Amal Mattu


This week we will continue discussing 6 more interesting prehospital EMS ECGs. Let’s start with this 78-year-old woman with PMHx of HTN who called an ambulance for generalized weakness associated with severe vomiting and diarrhea. She reports feeling dehydrated and having decreased urine output. She is found to be hypotensive, and stat labs show a potassium level that is only mildly elevated at 5.7 mmol/L. The following ECG was obtained:

Before watching the video, look closely at this ECG and ask yourself these questions:

  1. What ECG abnormalities do you notice?
  2. What is the most likely cause of the profound bradycardia seen?
  3. How would you manage this patient?