EMS_Cadet Posted July 14, 2006 Author Posted July 14, 2006 Alright..... This is the rhythm after the 2nd 12mg. dose of Adenosine. (The 1st dose was also 12mg.) Click here for the EKG The top strip is the rhythm at a slow rate. However, the Adenosine didn't seem to last to long because the rhythm converted to the bottom strip.
vs-eh? Posted July 14, 2006 Posted July 14, 2006 Alright..... This is the rhythm after the 2nd 12mg. dose of Adenosine. (The 1st dose was also 12mg.) Click here for the EKG The top strip is the rhythm at a slow rate. However, the Adenosine didn't seem to last to long because the rhythm converted to the bottom strip. OH YA!!!!! WHO CALLED IT!!!! GIMME SOME REPS YO! PS - The second strip looks more like an SVT than the intial set of strips. I can't make out any p-waves, even though it is only in lead II. If she is hemodynamcially stable still I'd let the hospital sort it out. Did you try vagal maneuvers before the adenosine, and if not...why?
EMS_Cadet Posted July 15, 2006 Author Posted July 15, 2006 Did you try vagal maneuvers before the adenosine, and if not...why? We did....They produced no results.
ncmedic309 Posted July 15, 2006 Posted July 15, 2006 I agree, the initial rhythm appeared to be SVT but considering the patients history and meds you can bet it's probably going to be atrial fibrillation or atrial flutter. I would attempt to slow it down for a better diagnosis with vagal maneuvers, if no response, throw some Adenosine at her and you should be able to determine the rhythm, as you did in this case. If her BP remained where it was, I would consider this stable and go ahead and treat it with Cardizem. Let's see if we can get that rate under control, and it will probably do away with that sensation in her chest. Good scenario...
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