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?
Image shown under Fair Use.
Monday, May 23, 2016
Subscribe to:
Post Comments (Atom)
2 comments:
Looks like a LBBB? New? Would need to r/o AMI
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.
Post a Comment