Florence Newham
introduction
Florence is a 59 year-old woman who comes into the emergency department after fainting. She describes feeling lightheaded over the past three days, especially when standing up quickly.
She is pale and dyspneic. The triage nurse notes her heart rate is 42, blood pressure is 84/52, and oxygen saturation is 86%.
What are your immediate steps?
Provide oxygen.
Perform ECG, or hook to a monitor.
Establish IV access.
The ECG reveals a third-degree block, with narrow complex QRS.
What do you do next?
For a type II second degree block, or third degree block, begin transcutaneous pacing without delay.
question: what do you use for sedation?
Consider atropine 0.5 mg IV while pacer is being established, to a max of 3 mg.
Consider epinephrine 2-10 ug/min or dopamine 2-10 ug/kg/min while pacer is being applied.
Resources and References
 |