The January 2011 EMS 12-Lead column has been posted at EMS1.com.
Not So Fast!
Given his age and the monitor “found” P-waves, I was wondering what folks used for “age-predicted maximal sinus rate” to evaluate for inclusion of SVT. 220-age gives 135 for this gentleman, a few papers suggest 208-(0.7 x age) which gives 148! Quite the range.
Granted I’m not suggested the rate be treated as SVT 🙂
Thought I would post here because there is so much dialogue on the other link.
Just a question…chris could probably answer.
Im going with pulsatile VT – maybe some rate induced ischaemic changes primarily STE inferiorly. Treat VT first obviously.
The question is if he has a pacemaker insitu and no spike seen does this mean the pacemaker has failed and this is the underlying rythm?
I need to review pacemakers etc…again 🙁
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