Below is a summary of Ryan’s EHR activity while he is in the ED. As an ED physician, you are responsible for examining the patient, ordering tests and procedures and diagnosing Ryan’s condition. Using his EHR, Virtual Physical Exam (VPE) and Internet research, answer the questions and be prepared to discuss the responses with the rest of Ryan’s health care team.

1. Internet Research: In the ED, advanced cardiac life support (ACLS) continues. Ryan is hooked up to the hospital’s standard defibrillator with monitor and is shocked for a fourth time with 200 joules. What is the purpose of defibrillation?



2. Review Ryan’s VPE: Ryan has 10 electrodes placed on his chest for a 12-lead electrocardiogram (EKG). Explain an EKG.
   
   Review Ryan’s ED EHR: What does Ryan’s EKG indicate?



3. Internet Research: During ACLS, you order Epinephrine and Amiodarone. What are these medications and why are they used?



4. Internet Research: Ryan responds to the ACLS measures, so you order a cardiac enzyme study, chest X-ray, non-contrast CT scan of the brain/head and echocardiogram. What information can you gather from each of these tests?


• Cardiac enzyme study:
• Chest X-ray:
• Non-contrast CT scan of the head:
• Echocardiogram: