Scenario: The electrocardiographic (ECG) rhythm strips in lead V1 shown below are 2 separate alarms from a 68-year-old man admitted to the intensive care unit (ICU) with respiratory distress. The patient has a history of chronic obstructive pulmonary disease (COPD) and diabetes. The ventricular tachycardia (V-Tach) alarm in strip A occurred soon after the patient was admitted to the ICU. The patient was short of breath (SOB) but was alert and oriented, his heart rate was 150/min, SpO2 90%, and blood pressure 112/68 mm Hg. Several more alarms with a similar ECG pattern occurred with SOB but no vital sign changes, and the alarms subsided once the patient was resting comfortably and his heart rate dropped below 100/min. The second strip (B) occurred just after the patient received a breathing treatment. The nurse noticed that during this alarm, the wide complex tachycardia at the end of...
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1 July 2020
ECG Puzzler|
July 01 2020
The Complexities of Wide Complex Tachycardias
Michele M. Pelter, PhD, RN;
Michele M. Pelter, PhD, RN
Michele M. Pelter is an assistant professor in the Department of Physiological Nursing, University of California, San Francisco.
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Teri M. Kozik, PhD, RN, CNS, CCRN;
Teri M. Kozik, PhD, RN, CNS, CCRN
Teri M. Kozik is director of clinical research–academic affairs at St Joseph’s Medical Center, Stockton, California.
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Salah S. Al-Zaiti, PhD, RN, CRNP;
Salah S. Al-Zaiti, PhD, RN, CRNP
Salah S. Al-Zaiti is an associate professor in the Department of Acute and Tertiary Care Nursing, University of Pittsburgh, Pennsylvania.
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Mary G. Carey, PhD, RN
Mary G. Carey, PhD, RN
Mary G. Carey is director for clinical nursing research, Strong Memorial Hospital, Rochester, New York.
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Am J Crit Care (2020) 29 (4): 325–326.
Citation
Michele M. Pelter, Teri M. Kozik, Salah S. Al-Zaiti, Mary G. Carey; The Complexities of Wide Complex Tachycardias. Am J Crit Care 1 July 2020; 29 (4): 325–326. doi: https://doi.org/10.4037/ajcc2020391
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