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Seen it twice. Would these scenarios qualify¿ Both 2 hours from cath lab, Unstable wide QRS systolic Regular 180 range relatively stable rate. Bp low 80s 1. Chest Pain with collapse. 12 lekg interpretation by remote cardiologist who recommended electricity ( I dont remember synch or unsynch) which failed. Eventual diagnosis Aortic Aneurism. 2. Febrile poor health status post MI patient successfully treated with fluids then ICU pressors (with one hand on the defibrillator). Eventually dx as aberrant Afib with Rapid Response.In your PEA you talk about detective work. History guided care more than 12 lekg and technology. Thank you for great lectures.
Monitor tech for 10 years here: I agree with the others in the comments this is more like IVR than agonal. Agonal looks like the tracing is being pulled at both ends. The wave forms get wider until the tracing flattens out to asystole.
@@ventilator98 IVR is between 20-40 bpm, wide qrs, no p wave, and usually a regular RR. Agonal rhythm has a worse prognosis. From my experience, patients go into agonal rhythm a few seconds or minutes before going into asystole and they don't usually come out of it. Agonal characterized by a really wide, abnormally shaped qrs and twave with very slow heart rate (usually less than 30 bpm) As I described, it looks the the tracing is being stretched from both ends with all the wave forms getting progressively wider and the heart rate getting progressively slower until the rhythm turns to asystole. In both IVR and Agonal rhythm the first course of action is to assess the patient; if they look like they're dying is probably agonal.
5 qualities of CPR. 1 .push hard. 2 inch in depth ,2 push fast not less than 100¬ more than 120/min 3.Allow chest recoil. 4Minimum interruption.5 Avoid Excessive ventilation ....Mark is best instructor 👍
Question, if the patient is stable, why not try the valsalva maneuver or something other than adenosine?? It seems that the patient was stable until adenosine was administered and then it’s downhill from there. I have seen that where the patient is just fine, then adenosine, and from there is cpr, epinephrine, and so on… Great video! Very informative :)
