William A. Ritchey

First impression is OH CRAP!! Pads would be a good idea and I agree with others on that. I would call it Wide Complex Tachcardia boarding on V Tach. With the HR AT 235 sweating and dipharitic you have here an UNSTABLE patient. I would t go straight to synchronized electrical cardioverson. 150 mg of amiodarone if the patient is stable. Adenocard would be a bad bad deal as to prove the diagnostic is SVT. If you stop he heart with Adenocard it will most likely kill this patient. Would want a MD opinion (if time permitted) but would be prepared for this guy to crash w/o notice. If he is not in Vtach now he soon will be. Haul butt to the hospital and treat the patient!! If stable it would be supportive care. I do not agree with others here that this patient is in anyway stable.

AS A PARAMEDIC I LOVE it when I already have someone on scene who has done an intial assesment and can give me a run down on my patients. I am very greatful and whatever agency responded to this MVC and basically gave you the finger needs to be asked whey they treated you this way. You did a great job and THANK you for doing it in case they did not say it. I am sure they did not. WTG!!