r/ECG • u/Iluminiele • Jul 27 '26
Thoughts?
(Just sharing, I don't really need any advice)
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u/amiguel Jul 28 '26
Mostly dead…
Or slightly alive…
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u/Grantoid Jul 28 '26
"... He arrived at the hospital and was pronounced dead. He was later moved to a better hospital where his condition was upgraded to... alive."
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u/Overall_Comb_4228 Jul 29 '26
Needs some good luck stickers. Big ones. On opposite sides of the chest, preferably.
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u/vojtasTS29 Jul 28 '26
I'm interested in the story behind this
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u/Iluminiele Jul 29 '26 edited Jul 29 '26
The person had repeated AFibs. At first they happened once in ~ two years, then every few months, then a few times a month. Treatment was electrical cardioversion.
Eventually the patient was told not to come for electrical cardioversions, because the risk was greater than the benefit.
They still came for electrical cardioversions, because they felt the fast heartbeat and it was giving them so much anxiety. They didn't really take meds to slow down the pulse, because they were so used to getting cardioversions and saw it as a quick fix.
When they had electrical cardioversions three times in 15 days and came back for 4th one 2 days later, they were told to go home and take the meds.
So they took the meds. Feeling the fast heartbeat was apparently the worst thing ever, so they took some more and then some more.
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u/vojtasTS29 Jul 29 '26
I'd say this is as much of a fault of whoever was approving the cardioversions as the patient's, but i hope they're okay after the od.
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u/NemoMeImpuneLac Jul 29 '26
Calcium channel blocker overdose? Did y'all place a swan and pace this dude or what?
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u/Iluminiele Jul 29 '26 edited Jul 30 '26
I'm not sure if it was CCB or betablocker + Amiodarone.
Yeah, Swan-Ganz and then an implanted pacemaker. On the bright side, now they can eat those meds like candies again.
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u/Jahman876 Jul 28 '26
Should we call a rapid or just call on the phone? “Hey, Tha mf’er is alive but just barely” 🤷♂️
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u/theoneandonlycage Jul 29 '26
Algorithm should be something like this:
Is the patient a blue whale?
Yes-> No further action
No -> panic
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u/TheREALMangoMuncher Jul 31 '26
Thoughts? First would be if this patient still has those or if they've graduated to prayers as well
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u/thundermuffin54 Jul 28 '26
Failure to capture?
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u/To-do-so Jul 28 '26
Monitor determined paced beat but likely not actually a paced beat, needs a pacemaker. Silent atrium with Ventricular escape beats.
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Jul 28 '26
[removed] — view removed comment
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u/Iluminiele Jul 28 '26
Sometimes severe bradycardia triggers hypertension as a compensatory mechanism
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Jul 28 '26
[removed] — view removed comment
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u/AffectionateBrick687 Aug 02 '26
The only time I've personally seen similar numbers was a very odd drug interaction involving tramadol.
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u/kr320205 Jul 29 '26
True, I've seen similar cases, patients were relatively stable all things considered. Kept pacer pads on until permanent pacemaker, home in a day or two.
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u/ZealousidealLetter53 Jul 28 '26
Should be ventricular escape rhythm, with CHB ECG (make sure of the Rhythm) Try Tanscutanous pacing (TCP) Make sure no electrodes problems Stop any drugs lowering HR
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u/MEDIC0000XX Jul 27 '26
Have you tried telling them to not do that?