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slowly, slowly…

October 14, 2012 By Christopher Partyka Leave a Comment

Case:

76 year old female, presents with lightheadedness and lethargy. She is complaining of mid-scapular pain & is syncopal at triage.

She has cold hands & clammy skin. Systolic BP 70 mmHg. Crackles to mid-zones of her chest. Distended JVP.

PMHx: AF (on metoprolol) & rheumatic heart disease (?mitral stenosis)

This is her ECG.

[Read more…]

Filed Under: Cardiology, ECG, Uncategorized Tagged With: adrenaline, atropine, bradycardia, heart block, isoprenaline

generally unwell (part 2)…

October 8, 2012 By Christopher Partyka Leave a Comment

For those joining the story for the first time, you can catch up here….

My interpretation of the ECG;

Sinus rhythm with 1st degree HB, an ‘odd’ axis. Wide complex QRS (~140-160ms) with symmetrical tall T-waves.
? Hyperkalaemia. Needs urgent bloods….

The nurse returns…

No one can place an IV or take bloods from her. So off you go, USS in tow to the bedside.

IV placed; bloods taken; urgent VBG to the iStat…..


[Read more…]

Filed Under: ECG, Uncategorized Tagged With: ECG, hydronephrosis, hyperkalaemia, obstructive uropathy

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