Scenario: This is a single lead I rhythm strip from the central monitor of a trauma intensive care unit. It was a level one alarm (life-threatening arrhythmia) with the computer interpretation of ventricular tachycardia. The patient is a 20-year-old white woman who sustained a high level (C4) spinal cord injury as an unbelted driver of a motor vehicle accident.

Interpretation: Normal sinus rhythm at 75 beats per minute with a sudden onset artifact.

The computer interpretation of ventricular tachycardia is eliminated because the QRS complexes march continuously through the rhythm strip. The differential diagnosis of atrial flutter is also eliminated because atrial flutter does not paroxysmally start within 1 cardiac cycle, then stop and then start again. The registered nurse finds the respiratory therapist at the bedside with the patient, who is wearing a specialized vest that helps clear excess mucus from the lungs of patients with spinal cord injuries....

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