ECG 1: Ventricular Tachycardia (VT) in a patient with a malfunctioning ICD.
What steps should we take?
Airway- Open, Maintain & Protect. If unresponsive- follow the BLS sequence.
Breathing- RR & SpO2~ Sats below 94%, start O2
Circulation: HR, BP, ECG, IV & Identify rhythm
Decision- Stable or Unstable? 🤔
Unstable= Synchronized Cardioversion ⚡️
Stable= Medications 💉
Our patient had a VT with STABLE vital signs and no serious signs & symptoms.
Treatment options:
-Amiodarone 150mg over 10 minutes. Repeat if VT recurs.
-Procainamide 20-50mg/min IV until arrhythmia is suppressed, hypotension ensues, QRS duration increases more than 50%, or a maximum dose of 17 mg/kg IV is given.
-Sotalol 100mg over 5 minutes
During the Amiodarone infusion, the patient developed ⏬ LOC, chest discomfort, SOB & ⏬ BP, and Synchronized Cardioversion was performed.
ECG 2: Synchronized Cardioversion at 100J
ECG 3: Post Conversion
For our post on Synchronized Cardioversion: https://www.theresuscitationcoach.com/post/rhythms-for-synchronized-cardioversion
See our video on Synchronized Cardioversion: https://www.theresuscitationcoach.com/post/defibrillation-cardioversion-tcp
ECG compliments from our friend at @ems_life_namibia
Disclaimer: This post is for educational purposes and is not intended as medical advice. While we strive for 100% accuracy, errors may occur, and medications or protocols may change over time.