There are some things in medicine that I feel require a standardized approach for rapid diagnosis & management, especially in the face of an unstable patient & you have a little sweat on your brow. The following are two somewhat straight forward cases that got me thinking …
66 year old self presents to ED following 4 hours of palpitations. She has had no chest pain, dyspnoea or pre-syncope. She has had this before.
HR 170. BP 128 systolic. Speaking full sentences with a clear chest. Sats 98%.
This is her ECG…
84 year old transferred to ED from the dialysis suite with 30mins of palpitations that commenced towards the end of his haemodialysis. He has no chest pain, dyspnoea or pre-syncope. He has had this before.
HR 160. BP 118 systolic. Speaking in phrases but clear chest. He looks grey & slightly clammy.
This is his ECG…
… both are broad, fast & regular leading me to investigate “Ventricular Tachycardia vs SVT with Aberrancy”