Wednesday, 12 January 2011

41 year old female CC: Chest pain - Conclusion

Here is the conclusion to 41 year old female CC: Chest pain

Paramedics give 150 mg amiodarone over 10 minutes via piggyback infusion.

The patient's BP drops to 90/48 and the patient's clinical status is observed to deteriorate.

Synchronized cardioversion is performed.

The rhythm is now narrow complex but extremely fast and unstable.

The ICD delivers a shock and the patient is observed to be in VF.

After waiting a few seconds (to see what the ICD is going to do) paramedics shock the VF.

The rhythm starts to stabilize and the patient's BP comes up to 142/74.

Are you ready to drop this patient off at the emergency department?