2018년 10월 8일 월요일

[update- exp] [CK] VT storm additional (exp.)

1st assessment and treatment.

Tx> ABC vital.
       Shockable? = shock -> main thing to save life.
       with Amiodarone IVP 150mg -> Lidocaine -> gtt as well.
       (on holding po meds. like sotalol for now...)

       Non shockable? = resuscitation with Epi.
     
Dx> EKG, telemetry(how fast HR? how many times? ICD or external?)

===============================================
Cause> electrolytes?, troponin?(EKG?).     
             medical history?(Afib, VT, whichever rhythm)
===============================================
S> Sx. of CP, SOB, Palpitation prior or after. any feeling?
     Did you feel shock or syncopized?

O> Vital
      P/Ex - HF?
      EKG
      Telemetry - in details? mono vs poly

AP>
      Risk of poly? then give Mg 2g IV
     

2nd escalate to CICU
with other AAD ? EP fellow ? EP attending involvement.

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