ECG case series for paramedics: December 2023

This 89-year-old female has presented with collapse and facial trauma. She has lived in a care home for the past 5 years. Despite having lived independently up until then, she was incapable of doing so after suffering from a stroke. She has since developed dementia. She can still mobilise short distances with the aid of a walking frame.

Over the last month, she has become increasingly fatigued and short of breath. This was attributed to a recent COVID-19 infection.

This morning, while mobilising to the toilet, she collapsed to the floor. She struck her head against the corner of a wall, resulting in a nasty laceration above her eye.

The care home staff called for an ambulance. When the paramedics arrived, she was still on the floor but conscious. She was very confused. Staff were applying pressure to a 6 cm laceration above her left eye that was bleeding profusely.

Her vital signs were:

She was attached to a 5-lead cardiac monitor and her ECG rhythm is shown in Figure 1.