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Wednesday, June 24, 2009

SVT....Oops...V-Tach

We got toned out about 1800 for a man with chest pain. When we arrived on scene we were met by his wife who escorted us inside. Her husband, who was in his 50's, was laying on the couch. He said that he had been working in the bathroom when he started to have chest pain and a little trouble breathing. We started getting a set of vitals and getting him on some oxygen when my firefighter told me that he had a fast pulse. We quickly hooked him up to the monitor and saw that he was in, what appeared to be, SVT at a rate above 240 beats a minute. I quickly had him try a Valsalva maneuver while I set up an IV. I tried 6 milligrams of Adenosine with no result. I then tried 12 milligrams with no result. About now the patient stated that he was starting to feel a little worse so I decided to turn to Edison Medison. Once I switched leads I immediately saw my, and my patients problem. He was in Ventricular Tachycardia. Now I know that there are going to be medics out there that just think that I'm a retarded medic. In my defense I found a rhythm strip of someone in SVT that had wider complexes than those of my patient in V-Tach...at least in lead II. If you can't tell I'm a little defensive about my mistake and it's a little difficult to admit that I'm fallable as a medic. Once I discovered that my patient was in V-Tach I shocked him. He said it hurt like hell but immediately felt better. He converted into NSR at a rate of about 88. I learned that I'm not perfect and that it doesn't hurt to check another lead on some heart rhythms. In the end it was a good learning experience since no one got hurt (except my ego).


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