Can you spell Wenckebach?

-
We were called for a diabetic problem. We fixed him right up but my partner became concerned when his initial heart rate was 38. That could be a problem. We printed out about a mile of EKG strip to figure out that he was in a second degree atrioventricular heart block type 1, aka Mobitz 1, aka a Wenckebach. (my parents love when I throw down the big words) Turned out that this was completely normal for him, but I explained that we didn't see this everyday which might explain our excitement and fascination. In fact when I did a 12 lead I think I said it was only to satisfy my own curiosity, as his was after all, a diabetic problem. He didn't mind and he was happily asymptomatic, as are most of these patients, but it looks cool anyway. Well, to nerds.
Unsurprisingly, the LP 12 interpretation was wrong.

Comments

PDXMedic said…
Diagnosis Wenckebach ...

It's AV nodal block and that's a fact ...

Take PR interval and lengthen that ...

Bradyarrythmia and heart attack ...


http://www.youtube.com/watch?v=GVxJJ2DBPiQ
12 August, 2009
Post a Comment

Popular posts from this blog

Dueling Blogs

-
I have the immense privilege to be sitting right across from Maddog Medic in the flesh. We aren't speaking, though he is listening to me. Want to solve this riddle? He is transcribing an interview he did with me for his blog at this very moment. And I too am blogging at this very moment! How crazy?! I am stationed this week at the EMS today conference to stock up on professional wheelings and dealings and learn some stuff. This is a wonderful conference full of networking and new products and I learned already that one dose of glucagon costs $130. That's out of control! I cannot wait to catch up on disaster literature and EMS tricks of the trade and get as many free pens as I can at the expo tomorrow.  As for now, I'm headed to a class on smart stuff and pediatric breathing problems.  I am surrounded by EMS nerds and I love it! I spent the day learning about things above my pay grade such as how to read a chest x-ray and how to differentiate between subarachnoi...
Click for More

Clothing Removal

-
Image
Last week I had a patient who fell from her horse while jumping at a show. When I got there the BLS crew had immobilized her and, well, that was about it. She was complaining of neck pain and at that moment couldn't remember what had happened. I used my horsey knowledge to build up a healthy rapport with a scared patient. In general, not a lot was wrong with her. My biggest problem was that she was on the backboard and still had on all of her fancy English riding clothes. I made my best efforts to get off her button up shirt with high collar and black outer riding jacket, but it caused her pain, and then I made it worse. Worse than falling off your horse, worse than the public embarrasment of having an ambulance called for you, worse than defenitly losing your show class, was the stupid paramedic who cut off your expensive riding clothes. I, too, had never felt worse for cutting someones clothes off. She cried and shrieked and you would have thought I was punching her in the gut. I...
Click for More

The Race

-
Sometimes this job is like a race. Like you're carrying this person on your back, and it's a messy race. You're tripping and sweating and you almost drop them. It's bouncy and there's trash everywhere. And if you can just get them over that line. To the line and throw them over. Throw them over and into the ER, you're obligation is fulfilled. Your job is done. You've won the race. And for a long time, that was it. Mission accomplished and I wasn't responsible for anything else. I didn't care about anything else. Get them to the hospital.  Dust my hands off and pat myself on the back. But somehow, they crept in. What did happen?  Did they live?  For the first time I asked myself.  I began to bring them home. I put them on a shelf and they stared down at me. They said, did you run fast enough?  Did you fall?  Did you drop me?  You threw me onto this island- over your line, but was it salvation?  I left in a hel...
Click for More