Nice P-SVT

[MICU]

Last night my team and myself got a call about a 50 yo. man that complain on chest pains. When we arive 56 years old man seats in his car sweat the hell out of himself and complains about palpition.
LP-12 shows PSVT 212 HR. (BP 120/70). Valsalva did not work, carotid massage out of question. 6mg Adnosein made no difrrence so are the two seconde dosses of 12mg...
The paramedic decided,cardioversion it is...Durmicume as anesthetion and a 50J sync shock in the MICU.
The rate began as bradicardia of 30-40HR and then recover to 80 NSR hr.

First time I saw a cardioversion on SVT, nice one.
Good Week everybody^_^

MICU- Israel

 

[Airwaygoddess]

Cardioversion, makes ya want to stay healthy! happy your patient responded well to the treatment! Hi MICU! ^_^

 

[VinBin]

I'm waiting to get my first cardioversion, anyone know the chances of a cardioverted pt. entering V.Tach or V.Fib after shock?

 

[Ridryder911]

I have only seen a very few that went into v-fib or v-tach after cardioversion, usually it is more successful the higher level of energy.

R/r 911

 

[chico.medic]

I'm waiting to get my first cardioversion, anyone know the chances of a cardioverted pt. entering V.Tach or V.Fib after shock?

Never seen it do that. The last cardioversion I had, we were called to one of the county fire stations for a walk-in medical. Got there and we were told our pt was having "an anxiety attack." Got to her and she was hyperventelating, altered, pale/cool/diophoretic, radial pulse too fast to count. Cut her shirt off, got her on the monitor, SVT@ 220, no b/p, placed the fast patches front/back and told her, "This is going to hurt!" Cardioverted her w/ 50J monophasic and she replied, "AHHHHHHHH, F__K!!!!!..............." She sat up, color returned to normal, ECG was a Sinus @ 76, she looked around, looked at me, slapped my arm HARD:unsure: , and said, "THAT HURT!!!!!!!! But I feel better, thanks!" :blush:

 

[VentMedic]

I'm waiting to get my first cardioversion, anyone know the chances of a cardioverted pt. entering V.Tach or V.Fib after shock?

That depends on the cause of the SVT. Chances of VT or VF increase with sepsis, hypovolemia, electrolyte imbalance, profound acidotic or alkalotic states etc. SVT with the underlying rhythm of Sick Sinus Syndrome is also not a pretty sight when cardioverted. Pacing readiness and expecting the unexpected is a must .