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Ventricular Tachycardia with ICD malfunction

ECG 1: Ventricular Tachycardia (VT) in a patient with a malfunctioning ICD.

What steps should we take?

Airway- Open, Maintain & Protect. If unresponsive- follow the BLS sequence.

Breathing- RR & SpO2~ Sats below 94%, start O2

Circulation: HR, BP, ECG, IV & Identify rhythm

Decision- Stable or Unstable? 🤔

Unstable= Synchronized Cardioversion ⚡️

Stable= Medications 💉

Our patient had a VT with STABLE vital signs and no serious signs & symptoms.

Treatment options:

-Amiodarone 150mg over 10 minutes. Repeat if VT recurs.

-Procainamide 20-50mg/min IV until arrhythmia is suppressed, hypotension ensues, QRS duration increases more than 50%, or a maximum dose of 17 mg/kg IV is given.

-Sotalol 100mg over 5 minutes

During the Amiodarone infusion, the patient developed ⏬ LOC, chest discomfort, SOB & ⏬ BP, and Synchronized Cardioversion was performed.

ECG 2: Synchronized Cardioversion at 100J

ECG 3: Post Conversion

ECG compliments from our friend at @ems_life_namibia

Disclaimer: This post is for educational purposes and is not intended as medical advice. While we strive for 100% accuracy, errors may occur, and medications or protocols may change over time.


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