fireflymedic Posted September 18, 2008 Share Posted September 18, 2008 check e medicine - it can give some great insight on ususual presentations. I've gone back and looked at it a few times after some patient's I've gone hmmm about more than once after finding out what was wrong with them. This did sound more like PE to me perhaps because I had an unusual presentation PE patient no long ago myself. I have seen mental status changes due to hypoxia due to massive PE (a single one usually doesn't cause this) the hypoxia also causing bradycardai and seizures. Though to the contrary I've also seen people maintain a respectable o2 sat around 95 or so with PE - it can be a tricky one. Good call. Link to comment Share on other sites More sharing options...
firedoc5 Posted September 19, 2008 Share Posted September 19, 2008 The only symptoms that were consistent with sludge are Salivation and defecation. Organophosphate poisoning is barking up the wrong tree, at this point. As far as terminology, a Premature Ventricular Contraction is a Ventricular contraction that occurs before the next expected "normal" heartbeat. Think of a patient in a rhythm such as Junctional Tachycardia. They are having ventricular contractions. The person then has a PVC, the PVC is called premature because it comes before the next expected ventricular contraction in a rhythm. A Ventricular escape complex is a ventricular beat that comes after an expected ventricular complex. The name of PVC is given because its origin is from the Ventricle. A ventricular contraction may originate from the Atrioventricular Node of the heart (called the AV Junction consisting of the AV Node and Bundle of HIS). This ventricular contraction would be called Premature junctional rhythm, or junctional escape rhythm. .................................................................Escape Complex.................................... ......................................................................|......... ............................................... /__/__/__/__/__/__/__/__/__/___/_/__/__/__/__/__/__/__ ..................................................................|............. ............................................... .......................................................This is where the beat was expected.............. ....................................................Premature Ventricular Complex.......................... ......................................................|......................... ............................................... /__/__/__/__/__/__/__/_/___/__/__/__/__/__/__/__/__/__ ........................................................|....................... ............................................... ..............................................This is where the beat was expected....................... OUTSTANDING, Matt. Proud of you. An easy way I remembered as a rookie about bradycardic PVC's is that there is an "irritation", which is dthe ventrical is trying to fire but there is connection with the atria (for whatever reason). I know that sounds really stupid but that is how it was first explained to us. We actually looked at the nurse telling us this with our mouths wide open. Link to comment Share on other sites More sharing options...
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