You’re a Nurse working in the ER and you're getting report
Paramedic Squad brings in a intoxicated 67- year- old male.
Patient was at a store arguing with a clerk who notified police.
Police arrived and patient complained of Abdominal pain. Ambulance was dispatched
Unable to obtain 12 lead EKG due to patients non-cooperation.
Patient states they consumed 1 liter of vodka. Patient has history of Alcoholism and Depression.
IV Fluids started. Respirations non-labored
Rhythm NSR with Stable vital signs shown on the Monitor
You look at the monitor and agree with assessment but as you prepare the patient for a 12 Lead EKG the alarms go off and you both look at the monitor. What do you see now?
You both agree the rhythm is a Wide Complex Tachycardia. Patient is pulseless & not breathing. You Defibrillate at 200 joules for Pulseless Wide Complex Tachycardia. Patient returns to previous rhythm. The EKG Badge confirms TorSades.
Always check the QT interval on an EKG closely with patients that have an Alcoholic History or are on Antidepressants. These type of medications, among many others can cause Prolonged QT Intervals which can cause Ventricular Rhythms
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