By David C. Sprigings, John B. Chambers
This very popular identify has develop into the definitive pocket advisor to the administration of scientific emergencies for front-line health facility medical professionals. It presents specific tips at the analysis and therapy of all universal stipulations and contains a step by step consultant to the 9 most vital sensible tactics in acute medication.
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Additional resources for Acute Medicine: A Practical Guide to the Management of Medical Emergencies
2) Yes No action needed No ECG identical with previously confirmed supraventricular tachycardia (SVT) with bundle branch block? 1) Yes Treat as SVT (p. 33) No Could this be pre-excited atrial flutter Yes or antidromic tachycardia? 1, Fig. 2) or antitachycardia pacing Refer to cardiologist 21 22 COMMON PR ESENTATIONS T AB L E 4 . 1 Broad complex regular tachycardia: differential diagnosis Broad complex regular tachycardia and management Arrhythmia Comment Management Monomorphic ventricular tachycardia (Fig.
2) • Second degree AV block, Mobitz type 2 (Fig. 3) • Third degree/complete AV block (Fig. 4) T AB L E 8 . 2 Second degree atrioventricular block, Mobitz type 1 (Wenckebach). Progressively lengthening PR interval followed by dropped beat. 1 Junctional bradycardia. Heart rate 30–60 bpm with P wave absent or position constant either after, immediately before or hidden in QRS complex. Occurs when junctional pacemaker overtakes slow sinus node pacemaker. 4 Complete atrioventricular block. Relationship of P wave to QRS varies randomly, and P waves are absent if there is atrial ﬁbrillation.
2) Suspect atrial ﬂutter with 2 : 1 block when the rate is 150 bpm Often associated with structural heart disease Vagotonic maneuvers and adenosine slow the ventricular rate to reveal ﬂutter waves See Chapter 7 DC cardioversion (p. 4) Discuss further management with a cardiologist Atrial tachycardia Caused by discrete focus of electrical activity P wave usually of abnormal morphology, at a rate 130300/min, conducted with varying degree of AV block May be associated with structural heart disease in older patients DC cardioversion (p.
Acute Medicine: A Practical Guide to the Management of Medical Emergencies by David C. Sprigings, John B. Chambers