Stable VT

Stable VT

65 year old, presented to the ED with palpitations for 2 hours.
— PMH: Hypertension and Ischaemic Heart Disease

Observations

A – Clear and self maintained

B – RR 15, Sats 98%

C – HR 200, BP 110/75

D – GCS 15

E – Temp 36.7°C

Clinical Findings

  • Broad Complex Tachycardia

  • No adverse features


Why We Simulated

Not all VT is pulse-less and you may well find a patient who has few signs or symptoms.

However it is important to look for the signs of compromise (see the infographic) and to be prepared should the situation escalate.

Close monitoring and ensuring the team know the plan should the patient deteriorate is vital. This is transferable to a variety of clinical situations not just arrhythmias.

Ask yourself:

  • "What will I do if my patient deteriorates?"

  • "How will I achieve this?"

  • "Does the team know the plan?"

These questions apply whether you are the team leader or not.

Further Reading:

Learning Points

  1. Our defibs default to lead 2 when switched on – you need to switch to paddles if the leads are not connected.

  2. It is important to ensure your team knows the management may need to escalate.

  3. Remember to utilise available resources in the department, such as Cardiac Specialist Nurses.

Positive Feedback

  • Identified the arrhythmia, and no signs of compromise were present.

  • Escalated the management from drugs to DC cardioversion.

  • Recognised the need for senior support and called early.

Edit & Peer Review by Jamie Sillett and Rebecca Prest
Lightning Learning: Falls Risk

Lightning Learning: Falls Risk

Delirium

Delirium