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EMTV Static Cardiology Card #2
Nov 12, 2024
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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
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