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Sunday, September 21, 2008

Changing Gears

We got toned out for an ill woman (just the type of call we all love to get) at about one in the afternoon. When we arrived on scene we were met by the woman's caretaker (loosely termed, nurse). The caretaker stated that she had been driving through the area on her day off and decided to call her client. She stated that her client wasn't feeling well so she decided to stop by and check in on her. The patient had been drinking for the last two days and was now throwing up partially digested blood. She also was not alert and oriented. While Grant started to get me vitals I started asking her questions. I also tried to get her bottle of alcohol from her which she grabbed onto tightly. As I put her on the monitor I continued my questioning. In the background I heard a fast beep, beep, beep, beep. It took me a second to realize that it was a her heart rate. It was trucking along at a rate of almost 200!

At that point I changed gears from treating a patient that had a drinking problem and a small GI bleed to treating a patient that had a severe cardiac problem. I quickly had Grant get her on oxygen, got an IV started and had her do a valsalva maneuver. When that didn't work I pushed 6 milligrams of adenosine, which is supposed to be like hitting control, alt, delete on windows 95 (if you are too young to know what this does...Google it). This took her heart rate from mid 190's to about 120. After a few seconds it went back up to about 160. At this point MBA showed up and loaded the patient up. I assume that they pushed some more adenosine to further slow the heart rate.



Her EKG strip.
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