Pt arrived via EMS presenting with unstable Ventricular Tach | Figure 1

luiisrn
Registered Nurse

Patient Report: Pt arrived via EMS presenting with unstable Ventricular Tachycardia. Pt was given Amiodarone 300mg en route. Pt was shocked at 150 joules in ER with no response. Pt was shocked again at 170 joules and converted to a sinus rhythm. Pt had a pacemaker placed two weeks ago.

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  1. Description: Pt. Came into the ER with a CC of afib that was found by his Apple Watch. Unable to cardiovert chemically so we sedated with etomidate and shocked at 150 joules. Has been shocked in 2015. All went well and patient went home not long after.

  2. Description: male pt in his 60s arrived by pov at the ER with fluttering in his chest. Initial heart rate in the 160s, reduced to 130-140 with beta-blockers. Pt stated last time this happened was 8yrs ago and they shocked him. He wants to be shocked again so he can go home. Pt sedated with 25mg etomidate and cardioverted at 200J. Kept overnight for observation, remained in NSR at 70.

  3. Description: EMS was dispatched to a chest pain for a 60 Y/O F. While enroute dispatch advised that she was nauseous and was having difficulty breathing. Upon arrival EMS made contact with the patient at the front door. She immediately went to the bathroom and vomited once. CPR was started and the pads were applied with the first shock being delivered within 60 seconds of collapse.

  4. Description: Second EKG, CT reports. Our dx was Cardiogenic shock, cardiac tamponade, pericardial effusion, elevated troponin. Cardiologist did not want ED to do pericardialcentesis. Pt was flown to a larger facility.

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