The following patients present to your fictitious ER near Hogwarts (though you are still a muggle and limited to non-magical medicine). Please describe the appropriate treatment.
75 yo F, known afib, noncompliant, presents with palpitations and is found to be in AFib with RVR. HR 150s, BP 130/80. Treatment?
Diltiazem/metoprolol (stable, irregular narrow complex)
75 yo F, known afib, noncompliant, presents with palpitations and is found to be in AFib with RVR. HR 150s, BP 60/20. Treatment?
Synchronized Cardioversion 120-200J biphasic, 200 J monophasic (unstable, irregular narrow complex
22 yo F known SVT, presents with near syncope. HR SVT @ 220, BP 60/20. Treatment?
Synchronized Cardioversion 50-100J (unstable, regular narrow complex)
22 yo F known WPW, presents with near syncope. HR Wide, regular @ 220, BP 60/20. Treatment?
Synchronized Cardioversion 100J
80 yo F multiple MI in past presents with chest pain. ECG wide complex, irregular at 200 BP 60/20. Treatment?
Defibrillation 200J!(unstable, irregular wide complex)
What does the ACLS guidelines tell you to do for each of the above patients?
Consider expert consultation
By Dr. Andrew Grock and Dr. Slappy Baguette (Dr. Sally Bogoch)
References
Robert W. Neumar,et al. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 8: Adult Advanced Cardiovascular Life Support. Link HERE
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