WITH COMPLETE SOLUTIONS GRADED A+
A 40 year old man arrives at the ER accompanied by his family. He is complaining
of palpitations after working outside for several hours. The assessment is as
follows:
SKIN: Hydrated, pale, warm and dry
CVS: Strong peripheral pulses and a BP of 125/80
CNS: Fully intact
RESP: RR is 22, no resp. difficulties, lungs CTA
You place o2 at 2L by NC on the patient and start an IV. The monitor shows a
narrow complex SVT (160).
What is your next intervention? - CORRECT ANSWER attempt vagal maneuvers
You have performed vagal maneuvers. The patient has shows no change on the
monitor.
What is your next step? - CORRECT ANSWER Give adenosine 6mg rapid IV
push. If no conversion, give 12mg rapid IV push
You give 6mg Adenosine rapid IV push with no effect. 12mg Adenosine rapid IV
push is then given. The patient develops severe chest pain. You see a change in
the rhythm.
The BP (not obtainable), and weak pulse. The patient also has LOC changes. Your
next step should be? - CORRECT ANSWER perform immediate synchronized
cardioversion