Arrhythmia Nursing Tachycardia 
Dr. Smith's ECG Blog
APRIL 15, 2020
Here is her ED ECG: Here is the ED physician's interpretation: IMPRESSION UNCERTAIN REGULAR RHYTHM, wide complex tachycardia, likely p-waves. LEFT BUNDLE BRANCH BLOCK [120+ ms QRS DURATION, 80+ ms Q/S IN V1/V2, 85+ ms R IN I/aVL/V5/V6] Comparison Summary: LBBB and tachycardia are new. This is clearly ventricular tachycardia.
Dr. Smith's ECG Blog
AUGUST 3, 2018
In the evening, a middle-aged man complained of chest pain at the nursing home. Nurses found him with a BP of 50/30 and heart rate of 130 and called EMS. There is a narrow complex tachycardia at a rate of 130. I’ll focus my comments on arrhythmia diagnosis. He was awake, with a pulse of 130 and BP of 50/30. Is is sinus?
Dr. Smith's ECG Blog
NOVEMBER 30, 2019
Is it ventricular tachycardia (VT) due to hyperK or is it a supraventricular rhythm with hyperK? She had home health nurse visits, and a BMP was sent the next day (the day prior to admission, presumably after 120 mEq of KCl replacement -- if she was taking as directed). It would be difficult to get a nurse to give it faster!
Dr. Smith's ECG Blog
FEBRUARY 2, 2017
Here is the ECG: Sinus tachycardia. IV administration of potassium is indicated when arrhythmias are present or hypokalemia is severe (potassium level of less than 2.5 malignant ventricular arrhythmias are present), rapid replacement of potassium is required. This patient presented with severe DKA. What do you think? What else?
Dr. Smith's ECG Blog
APRIL 8, 2016
See here for management of Polymorphic Ventricular Tachycardia , which includes Torsades. IV administration of potassium is indicated when arrhythmias are present or hypokalemia is severe (potassium level of less than 2.5 malignant ventricular arrhythmias are present), rapid replacement of potassium is required.
Dr. Smith's ECG Blog
OCTOBER 8, 2023
Triage is backed up, and 10 minutes into your shift one of the ED nurses brings your several ECG s that has not been overread by a physician. Imagine you just started your ED shift. It's a busy Friday afternoon. All of the patients presented with chest pain , and they are all in triage.
Dr. Smith's ECG Blog
APRIL 9, 2025
I'll never forget when I ordered such an infusion in 1991 and then my patient started seizing and I looked up and the nurse had hung the lidocaine wide open! If breakthrough ventricular arrhythmias occurred, additional 50-mg boluses were given every 5 minutes, as needed to a maximum of 325 mg. DOI: 10.1016/j.resuscitation.2025.110515
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