Monday, May 23, 2016

Atropine

You are an emergency physician attending in a busy ER. A resident comes up to you with this EKG and says it's from a person who was "found down." She administered atropine but there was no increase in heart rate.

Challenge: Why not?

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2 comments:

  1. AnonymousJune 5, 2016 at 8:38 PM

    Looks like a LBBB? New? Would need to r/o AMI

    ReplyDelete
  2. CraigJune 6, 2016 at 1:33 PM

    weird looking EKG, right? what looks like a widened QRS is actually Osborn waves.
    -
    Atropine

    The EKG is consistent with systemic hypothermia; it shows sinus bradycardia with marked Osborn waves in V4 and V5 as well as T wave inversion and QT prolongation. According to a May 3, 2016 JAMA article, “bradycardia is not vagally mediated, so it can be refractory to atropine.”

    Sources: JAMA, ECG Wave Maven.

    ReplyDelete

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