Hello, med students. This episode has been sponsored by Freed AI. Do you dread the thought of

endless charting once you become a doctor? Do you think that doctors should be spending more

time with our patients and less time mindlessly writing notes? Freed AI is the product for you. It is a

secure, hippocompliant scribe that anybody can use.

Focus your energy on what matters, providing good patient care.

Use coupon code EM50 to save 50% the first month you try it,

and you can cancel at any time if you decide it's not right for you. You can learn more

at www.gitfreed.a.i. Hello, med students. My name is Zach Olson. Thank you for downloading

this episode of the EM Clerkship Podcast. It's a beautiful morning. The sun is rising. The birds are singing.

You're starting your shift. Nice and relaxed. Fresh cup of coffee in your hand. Walk and pass that

EMS radio again. And you get a call. University Hospital's Ambulance 48 coming to you ALS with a code code stemmy, 62-year-old male, sudden onset of chest pain, rated 8 out of 10, radiating to the right arm.

Past medical history of angioplasty two months ago is showing ST elevation in three leads, currently pulse a 172 BP 102 over 64, respirations of 26.

We have them on 15 liters, O2, and is setting at 95%.

Aspirin and nitro on board, as well as IV established, approximately 10 minutes out.

Welcome to emergency medicine, guys. Are you kidding me? There is no relaxation here. My first shift as an intern. This was me. I literally walked in and my attending gave me a choice between running the code in trauma bay 2 and running a stemmy alert right next door. Today, we're choosing the Stemie.

ST elevation, myocardial infarction. In all of emergency medicine, stemmy is king. On your test,

Stemmy is king. We get hundreds of EKGs every day looking for this specific diagnosis, looking for

that critical pattern, and when you see it, you have to know what to do. In 2013, the American

Heart Association published a set of guidelines on the management of STEME, and today that is what we're going to cover.

But before we get into our approach, first, we need to talk about the actual diagnosis of

STEMI. And what you need to know is that STEMI is purely an EKG finding. You can't count on

elevated troponins or SKMB or anything like that. It's a

...