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A 50-something with Regular Wide Complex Tachycardia: What to do if electrical cardioversion does not work?

Dr. Smith's ECG Blog

Pads were placed with ultrasound guidance, so they were in the correct position. If you don't know what the dysrhythmia is, then try procainamide. Definitive diagnosis that ECG #1 is in fact VT is more than academic. If it is VT, adenosine is safe but not effective. Shocked x 2 without effect. What to do now?

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Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Academic Emergency Medicine., Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. orthostatic vitals b.