By David C. Sprigings, John B. Chambers
This very popular identify has turn into the definitive pocket advisor to the administration of clinical emergencies for front-line sanatorium medical professionals. It offers specified assistance at the analysis and therapy of all universal stipulations and contains a step by step consultant to the 9 most vital useful approaches in acute drugs.
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Extra info for Acute Medicine: A Practical Guide to the Management of Medical Emergencies
G. myocardial infarction). g. ventriculo-atrial dissociation, capture or fusion beats and QRS concordance) are speciﬁc but not often seen. Broad complex regular tachycardia 24 COMMON PR ESENTATIONS Broad complex regular tachycardia F IG U R E 4 . 2 Pseudoventricular tachycardia. There are native QRS complexes at the cycle length of the baseline rhythm within the artifact, best seen in C4 and C5. 5 mg/kg over 2 min Maintenance: 1–4 mg/min VT, ventricular tachycardia. 5 Broad complex irregular tachycardia See p.
2) Manage as acute coronary syndrome (p. 169) with urgent coronary angiography and revascularization if ischemia is suspected or cannot be excluded Refer to a cardiologist Continued Broad complex irregular tachycardia Without preceding QT prolongation 29 Broad complex irregular tachycardia 30 COMMON PR ESENTATIONS Arrhythmia Comment Management Pre-excited atrial ﬁbrillation (AF) in WPW syndrome (Fig. 1) AF conducted predominantly over accessory pathway Ventricular rate typically 200–300/min QRS morphology similar to delta wave during sinus rhythm DC cardioversion (p.
1) Check electrolytes/creatinine ECG abnormality due to artifact (pseudoventricular tachycardia)? (Fig. 1) Yes No action needed No ECG consistent with atrial Yes fibrillation (AF)? 1) No Atrial fibrillation (AF) with bundle branch block or pre-excited AF (Fig. 1) QT prolongation before ventricular tachycardia (VT)? Yes No • Stop drugs which may prolong QT interval • Correct hypokalemia (p. 447) • Temporary pacing (p. 2) • If evidence of myocardial ischemia, manage as acute coronary syndrome (pp.