Static Cardiology Lecture Notes

Introduction

• Presenter: EMTV
• Topic: Static Cardiology cards and scenarios
• Purpose: Mimic average time spent on each card in National Registry Static Cardiology Station

Card Scenario

• Patient Description: 78-year-old male, profoundly bradycardic, non-responsive to verbal stimuli
• Initial Rhythm Observation: Absence of P wave with every QRS complex indicating a possible block

Cardiac Rhythm Analysis

• P Waves: Present but not consistently married to QRS complexes
• QRS Complexes: Following their own intrinsic rates, indicating dissociation
• Diagnosis: Third degree heart block

Stability Assessment

• Criteria for Instability (CHAD):
  • Cardiac insufficiency
  • Hypotension
  • Alteration of mental status
  • Dyspnea
• Patient Signs:
  • Weak and dizzy
  • Non-responsive to verbal stimuli (altered mental status)
  • Blood pressure: 78/50 (hypotensive)
  • Pulse: 30
  • Respirations: 8 and irregular (dyspneic)
• Conclusion: Unstable third degree AV block

Treatment Plan

• ACLS Algorithm: Unstable gets the cables (focus on electrical treatment)
• Initial Steps:
  • Scene safe BSI IVO2 monitor
  • BBM patient due to inadequate ventilation (SpO2 84%)
• Electrical Treatment:
  • Transcutaneous pacing function on monitor
  • Set pacer rate: 60-100 bpm
  • Increase milli amperage until electrical capture (pacemaker spike followed by ventricular beat)
  • Check for mechanical capture (carotid pulse)

Additional Considerations

• Transport: Rapid transport recommended
• Vasopressor Infusion: Consider dopamine if knowledgeable about drug doses

Conclusion

• Encouragement: Subscribe and use static cardiology cards for practice
• Closing: Have a good night and see you next time