V-tach

[medic403]

Now some of you have seen me on here once or twice. I do have a question for all seasoned ems, docs., nurses. I had a asymtomatic 58 y o male pt on New years day in V tach rate 250+. c/o n/v and stiff neck. How often does this happen. This pt did not make it. This call I can not go into much detail as of yet, has burnt me. Please don't be to hard on me I'm already going through enough and a friend would be much more appreciated at this time. thanks.

[Thunderchild145]

What, starts out asymptomatic but ends up coding and dying? This happens all the time. V-tach is a non-surviveable rhythm. Even without symtoms it has to be converted or the pt will code. Always.

[ERDoc]

What, starts out asymptomatic but ends up coding and dying? This happens all the time. V-tach is a non-surviveable rhythm. Even without symtoms it has to be converted or the pt will code. Always.

Not true. Admitted a guy to the CCU with stable VTach. We tried to chemically and electriclally convert him in the ER. He ended up on I believe a procainamide and amiodarone drip in the CCU. He ended up being transferred to another facility to have an ablation of an accessory pathway 3 days later. Never decompensated and only complained of intermittent palpitations.

403, without much detail, it sounds like you might have gotten a bad role of the dice, but again that is hard to say. VTach that is stable can become unstable.

[OzMedic]

Now some of you have seen me on here once or twice. I do have a question for all seasoned ems, docs., nurses. I had a asymtomatic 58 y o male pt on New years day in V tach rate 250+. c/o n/v and stiff neck. How often does this happen. This pt did not make it. This call I can not go into much detail as of yet, has burnt me. Please don't be to hard on me I'm already going through enough and a friend would be much more appreciated at this time. thanks.

Sorry, not sure what n/v means. Just a query, are you sure it was a VT and not a SVT with aberrant conduction? The only reason I ask is that 250 is pretty quick for a VT especially in a conscious patient. If I see rates that fast with a wide QRS in a patient that is still perfusing ok I start to get a bit suspicious. If it was in fact a SVT then a lot of other possibilities come up. A bit more information would probably help. PM me if you like, I'm in Australia so there is not much chance of there being a conflict if that is what you are worried about.

[medic001918]

Without being willing to provide the details of the call, you'll have a hard time getting any kind of decent feedback regarding your specifica scenario. I can understand that the call may be bothering you and you might be coming under fire from supervisors or medical control...we can't really tell you too much based on what information you've provided other than that a patient in v-tach can decompensate and die very quickly. If you provide more information, we may be able to provide more answers.

Shane

NREMT-P

[Ridryder 911]

What, starts out asymptomatic but ends up coding and dying? This happens all the time. V-tach is a non-surviveable rhythm. Even without symtoms it has to be converted or the pt will code. Always.

Obviously, you have never worked a CCU or ICU, I agree with ERDOC. We routinely see V-tach on a hourly, daily basis, that we never treat because this is normal for the patient. This could be caused by many factors either electrolyte imbalance to ischemia or just an irritable foci, who knows most of the patients never code or ever have any s/e from it. Again, treat the patient not the monitor.

R/r 911

[ncmedic309]

I would like a lot more details on the patients presenation. The more you can give, the more we can give...

[Dustdevil]

What, starts out asymptomatic but ends up coding and dying? This happens all the time. V-tach is a non-surviveable rhythm. Even without symtoms it has to be converted or the pt will code. Always.

LMAO!!

Yes, and if you drop a bottle of NitroStat, the resulting explosion will blow a crater the size of Terra Haute in the ground too. Always.

Here's an ALWAYS rule for you: ALWAYS think very carefully, and do thorough research before putting your reputation on the line with an "always" statement. :wink:

[Thunderchild145]

Obviously, you have never worked a CCU or ICU

True. I've obviously been told wrong that all V-tachs will eventually deteriorate into codes. Ah well.

LMAO!!

Yes, and if you drop a bottle of NitroStat, the resulting explosion will blow a crater the size of Terra Haute in the ground too. Always.

Here's an ALWAYS rule for you: ALWAYS think very carefully, and do thorough research before putting your reputation on the line with an "always" statement. :wink:

Don't patronize me. I'm not a retard. I've just been taught incorrectly.

[Just Plain Ruff]

In the presence of Nausea and vomiting I would have to say that V-tach woudl be an ominous sign.

I'd suspect and MI that has progressed to a very very irritated heart. sounds like the guy was about to code anyway but without more info it's hard to tell

Just remember and I'm sure you know this, some patients die!!! No matter what you do, what you try to do and what others try to do they Die!!! It's just a fact of ems life.

PM me if you need a good shoulder or ear to chat.