Not Yet Bored Review

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

 

The views expressed on this blog are the author's own and do not reflect the views of their employer. Please read our full disclaimer here. Any references to clinical cases refer to patients treated at a virtual hospital, Janus General Hospital.
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andygrock

  • Resident Editor In Chief of blog.clinicalmonster.com.
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  • Resident at Kings County Hospital