Like a band-aid

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We arrived to find a lady looking well chatting with the BLS crew. We were both fairly certain that they were going to cancel us. Then the EMT turned to me and asked if I'd ride along. Sure, it gives me something to do. So I set up for an IV and threw her on the monitor. My partner said 'You okay?' and I said 'yep', and he shut the doors and left. As I turned away from him I was distracted by this annoying beeping coming from the monitor. Oh, that's the patients' heartrate. Oh, that's the patients' heartrate at about 170. Oops. So I got cracking on the IV and made sure of her complaints. She said she felt fine except for a little tightness in her chest, and some shortness of breath. Yes, fine. She was in a-fib with RVR (or atrial fibrillation with rapid ventricular response, for all those who like it when I use big words)
So I tried to get her to vagal out of it, and she was giving it a good try, but without success. I called medical command in the hopes that we could skip adenosine and go straight for the throat with cardizem. I got my orders and excitedly pushed the drug (as it was the first time I'd given it.) And....nothing. Oh well. We pushed on to the hospital and after a few minutes of her being there, they untaped my IV bag so that they could get her shirt off. In the process they invented a new vagal maneuver: ripping tape off of a hairy arm! As you can see in the following scans, she was taching along, had a strange period of asystole and converted into a sinus rhythm!

Comments

Unknown said…
I had one of those this past Friday night, but he didn't convert either with meds or the tape being ripped off of his hairy arm. Cardioversion was his friend.....
13 April, 2008
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