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Here is his 12-lead: There is a wide complex tachycardia with a rate of 257, with RBBB and LPFB (right axis deviation) morphology. Read about Fascicular VT here: Idiopathic Ventricular Tachycardias for the EM Physician Case Continued He was completely stable, so adenosine was administered. See Learning point 1 below.
It is seldom done in pediatric age group. There is a potential risk for drug challenge in that life threatening ventricular arrhythmias could be precipitated. Hence drug challenge is to be done only in a monitored intensive care facility. With proper precautions, risk can be reduced.
Otherwise vitals after intubation were only notable for tachycardia. An initial EKG was obtained: Computer read: sinus tachycardia, early acute anterior infarct. Pediatric and elderly patients were more predisposed to developing an arrhythmic event in the setting of fever [7]. A rectal temperature was obtained which read 107.9
Answer : you must treat the patient's underlying condition causing sinus tachycardia, and repeat the ECG at the lower heart rate. Optimal QT interval correction formula in sinus tachycardia for identifying cardiovacular and mortality risk: Findings from the Penn Atrial Fibrillation Free study. which is 0.6 So is it really prolonged?
There is sinus tachycardia and also a large R-wave in aVR. Drug toxicity , especially diphenhydramine , which has sodium channel blocking effects, and also anticholinergic effects which may result in sinus tachycardia, hyperthermia, delirium, and dry skin. Her temperature was 106 degrees. As part of the workup, she underwent an ECG.
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