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I agree with everything you have said and considered it before posting. I should have been more thorough. I agree that a rate of 120 is low for vtach but its not unheard of. Although the pacer may be causing this, right now theres no way to know, is there? Do you have a follow up, or were you...

How can you tell it is a paced rhythm? I see no pacer spikes. The patient has a wide complex tachycardia with negative concordance in all of the precordials and a positive QRS in avl. This appears to be vtach in my opinion.

Looking for employment near Myrtle Beach. My fiance is a PA and is relocating and so I must find a job. Would like places with 911 and progressive. Thank you for your input.

Great video Tom! Was just reviewing the video and their protocols. Really progressive. I am from Richmond, KY and I think one of my co-workers is trying to relocate to your area.

I recently read that Lido is not a good diagnostic agent, and that it can cause v-tach to not be treated as such because it did not respond to lidocaine. What about in a patient who has no response to lidocaine, and you still don't know if it was SVT-A or V-tach? When do you just decide to...

Christopher, In what cases would you give amiodarone?

Immediately after the patient arrested he was clinched during that period and it remained after rosc. I equated the trimsus with the seizure because I did not know any other reason. After researching on the Internet cadaveric spasm seemed more feasible. I thought I said that before but I may not...

I had a patient like this once but it remained after he was resuscitated. Thought that could have been a seizure but later found Cadaveric spasm's. I tried to explain to my director that I could not intubate because the patients mouth would not open. I was able to insert a king airway in shortly...

Yes and as long as pt is stable I would push adenosine, then maybe I could make out p waves a little better.

I'm still going with a flutter. Thought I saw some "blips" of p waves some buried in the t waves

Haha sorry had to say it

Treat the patient not the monitor?

What about a-flutter?

I think it looks like a early mi and probably deserves Cath lab. Did you say there was dynamic ekg changes? I think with the changes in I and avl its pathological. Would rather Christopher or tom comment on the ecg though.

I tried to get this approved for me to try in our service, but now we have the lucas so we can just shock away.

Sorry I am aware of the various wave forms but do you mean that if the plateau is too low it means that the patient cannot produce enough effort to overcome the pressure of the c-pap? I am just trying to understand the statement. I may not have worded my question appropriately.

Can you explain these two further please in regards to the waveform and plateau?

We recently had a trauma symposium in my state were some of the local hard hitting trauma docs attended. There was a paramedic who gave a lecture on spinal immobilization and brought up many of the references that many of you already know. There was one that was new to me and it has been hitting...

Rigor I mean.

Could it be instantaneous trismus?