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Bieber

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250ml fluid challenge see if there's any change.

One post you said hr of 280, an other 180, and you keep switching between a him and a her, is it a transsexual who's having an anxiety attack because there are strangers around? :P

I did? My bad, rate's 280.

You got your IV, you're pumpin' fluid in. Waiting for that to go. =)

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pads/ electrodes.....DC shock for sync. cardio version...dont stuff around people..........

1st at 100j

2nd at 150j

3rd at 200j

unsuccessful then Amiodarone

50mg (1ml) IV undiluted bolus

repeat every 3 minutes whilst indication persist

Max dose; 300mg (6ml)

if that fails....urgent transport

Edited by craig
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Chest pain, Diaphoretic....

I'll go with 100 Fentanyl, 2.4 Midazolam and then cardiovert

If that dosent work we can try 12 of Adenosine.

If all else fails Amiodarone 150mg in 50ml minibag ran over 5min.

I do not support wasting time trying fluids of excessive vagals with that high of a heart rate, and chestpain WITH cardiac symptoms (nausea, clammy, sweaty).

Basically give them a 5ml syringe and ask them to blow the plunger out of it, if they don't slow thier rate they require further treatment.

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My fluid idea was based off the 180 hr. I agree, 280 is nothing to mess around with.

I'm curious why cardiovert before drugs? He's maintaining a pressure. It's a dual paramedic crew, one could administer drugs while the other preps for cardiovert in case the drugs don't work.

I've never seen cardioversion done at that high a rate, wouldn't it be difficult to sync? And aren't you risking a more lethal rhythm? I know if it needs to be done it needs to be done but wouldn't it be more prudent to try the drugs first?

I'm sorry if these are stupid questions, it's the way I understand this, if I'm wrong, please correct me.

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