That wriggly line

 

This SAQ is worth 14 marks

A 48 year old man has been brought to the ED with chest pain and dizziness for the last 1 hour.

His vital signs are:

GCS 14 E4 V4 M6
BP 80/45 mmHg
O2 sats 99% 6L O2 via mask
Temp 36.5 degrees

His ECG is attached.

View attached:  Attachment 1

Question 1.
What is your diagnosis of the rhythm displayed in the ECG? (1 mark)


______________________________________________________________________________________________



Question 1.
List 3 supportive features from the ECG. (3 marks)

1. ___________________________________________________________________________________

2. ___________________________________________________________________________________

3. ___________________________________________________________________________________



Question 1.
List 4 likely causes of this problem. (4 marks)


1. __________________________________________________________________________________________

2. __________________________________________________________________________________________

3. __________________________________________________________________________________________

4. __________________________________________________________________________________________



Question 1.
List 3 management steps you will undertake in the ED. Provide doses where appropriate. (6 marks)

1. _______________________________________________________________________________________

__________________________________________________________________________________________

2. _______________________________________________________________________________________

__________________________________________________________________________________________

3. _______________________________________________________________________________________

__________________________________________________________________________________________



 

This SAQ is worth 14 marks

A 48 year old man has been brought to the ED with chest pain and dizziness for the last 1 hour.

His vital signs are:

GCS 14 E4 V4 M6
BP 80/45 mmHg
O2 sats 99% 6L O2 via mask
Temp 36.5 degrees

His ECG is attached.

Question 1.
What is your diagnosis of the rhythm displayed in the ECG? (1 mark)

VT

Question 1.
List 3 supportive features from the ECG. (3 marks)

Broad complex QRS

Tachycardia rate approx 180

Presence of capture beats



Question 1.
List 4 likely causes of this problem. (4 marks)

Cardiac Ischaemia 

Electrolyte – hypokalaemia, hypomagenesemia 

Drug – eg tricyclics 

Primary arrhythmia 

Congenital 

Cardiomyopathies 

Infiltrative diseases



Question 1.
List 3 management steps you will undertake in the ED. Provide doses where appropriate. (6 marks)

Sedate – fentanyl 25mcg boluses, midazolam 0.5 – 1mg boluses

Synchronized DC cardioversion – 100 – 200J

Correct underlying cause

 

Total pass 8/14 – corrects to 5.5/10 




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ECG   arrhythmia