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On arrival, the patient was in shock, was intubated, and had an immediate cardiac ultrasound. What does a heart look like on ultrasound when the EKG looks like that? Here you go: It's not the world's greatest cardiac ultrasound video, but it does appear to show poor function and low volume. They transported to the ED.
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. Here was his prehospital ECG, which I viewed immediately while the resident performed cardiac ultrasound: What do you think? I’ll focus my comments on arrhythmia diagnosis.
Bedside ultrasound showed no effusion and moderately decreased LV function, with B-lines of pulmonary edema. 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.
On arrival in the ED, a bedside ultrasound showed poor LV function (as predicted by the Queen of Hearts) with diffuse B-lines. 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! Initial BP was 120/96, HR 102, SpO2 98%.
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