DFIB Posted August 31, 2011 Author Posted August 31, 2011 (edited) The patient had Atavan and was just waking up. That was the problem. every time she would regain contiousness she would V Tach. The shock delivery in cuestion was delivered in route to ICU in the hall. There was no chance for other meds. She just grunted, kinda coughed once and blinked a couple of times. I was impressed. Thanks for the input guys. Good info to know. Edited August 31, 2011 by DFIB
Asysin2leads Posted September 1, 2011 Posted September 1, 2011 I'm not going to arm chair quarterback, but it is rarely right nor ethical to perform a pain or anxiety producing procedure on an alert or conscious patient without an anxiolytic or analgesic. Obviously a life saving intervention would be one of these, but synchronized cardioversion isn't in that category. The fact she was under the influence of Ativan already may have been why medication was no given pre-synchronization. If someone needs to be cardioverted, give them the meds, give it time to work, and do it humanely. That would be my advice. 1
Kiwiology Posted September 1, 2011 Posted September 1, 2011 For VT, I have been fortunate enough to not have had a failure. You can get some hypotension with propofol ... Ketamine FTW If I can't convert them after 3 shocks, I call one of the smart doctors (cardiology) to figure out what to do next. Just ask the Consultant
Just Plain Ruff Posted September 1, 2011 Posted September 1, 2011 Ketamine FTW Just ask the Consultant isn't that the expert consultation that ACLS recommends?????
Just Plain Ruff Posted September 1, 2011 Posted September 1, 2011 I dno we don't have "ACLS" here you Kiwis, just got to buck the trend don't ya. What do you have in place of ACLS?
Kiwiology Posted September 1, 2011 Posted September 1, 2011 (edited) you Kiwis, just got to buck the trend don't ya. What do you have in place of ACLS? The principles of management of cardiac problems (cardiac arrest, VT, symptomatic bradycardia etc) are incorporated into the BHSc (Paramedic) during second year and specific guidelined are publishes by the Ambulance Clinical Management Group from the consensus of international evidence. Edited September 1, 2011 by kiwimedic
Just Plain Ruff Posted September 1, 2011 Posted September 1, 2011 The principles of management of cardiac problems (cardiac arrest, VT, symptomatic bradycardia etc) are incorporated into the BHSc (Paramedic) during second year and specific guidelined are publishes by the Ambulance Clinical Management Group from the consensus of international evidence. Cool. You mean you can run a code without a ACLS Card???? Who'd have thunk it.
ERDoc Posted September 1, 2011 Posted September 1, 2011 ...from the consensus of international evidence. That's just ACLS without paying the fees for the name.
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