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.

Tachycardia 52

Tachycardia Nursing Heart Disease Dysrhythmia 52

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!

Cardiac Arrest 40

Cardiac Arrest Tachycardia Nursing Ultrasound 40

Dr. Smith's ECG Blog

FEBRUARY 2, 2017

Here is the ECG: Sinus tachycardia. So the real QT is shorter, but the computer does not mention the U-wave, and the U-wave is as important as the T-wave in predicting cardiac dysrhythmias. This patient presented with severe DKA. What do you think? The computer and physician reader wrote: "ST depression, consider subendocardial injury."

Cardiac Arrest 52

Cardiac Arrest Dysrhythmia Arrhythmia Nursing 52

Dr. Smith's ECG Blog

APRIL 8, 2016

See here for management of Polymorphic Ventricular Tachycardia , which includes Torsades. Could the dysrhythmias have been prevented? It would be difficult to get a nurse to give it faster! Severe hypokalemia in the setting of STEMI or dysrhythmias is life-threatening and needs very rapid treatment. Is 40 mEq too much?

STEMI 52

STEMI Myocardial Infarction Cardiac Arrest Arrhythmia 52