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It is 7:30 a.m. You are about to finish your fourth overnight in a row, and a 65 y.o., white male, Vincent Tacicardia, with a history of HTN is BIBEMS with a complaint of chest pain since he woke up this a.m. (1 hour ago). He describes the pain as substernal, associated with shortness of breath. He is awake and alert. He describes prior episodes of palpitations but denies prior chest pain. PE reveals an anxious, alert WM approx 80 kg HR 190 ireg., BP 140/80 rr 24, POx 95% RA, T 98.4. Skin is pale no cyanosis HEENT reveals no JVD, lungs are clear. Heart exam is tachy and irreg. Extremites are without edema. Rectal is brown stool, heme negative. |
| 1. | Given above history, what is your immediate intervention? | ||
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| 3. | What would you like to do next? Discuss ACLS protocol for this patient. | ||
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| The patients heart rate slowed to 125 after Lidocaine bolus and drip. He was also given Ativan in preparation for cardioversion, but was not cardioverted. After slowing the patients heart rate the patient continued to experience chest pain. | |||
| 4. | Discuss the indications for thrombolysis? Does this patient meet criteria? | ||
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