By David C. Sprigings, John B. Chambers
This very popular identify has develop into the definitive pocket consultant to the administration of scientific emergencies for front-line sanatorium medical professionals. It offers specific assistance at the analysis and remedy of all universal stipulations and contains a step by step consultant to the 9 most vital sensible approaches in acute drugs.
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Extra resources for Acute Medicine: A Practical Guide to the Management of Medical Emergencies
1, Fig. 2) Yes No action needed No ECG identical with previously confirmed supraventricular tachycardia (SVT) with bundle branch block? 1) Yes Treat as SVT (p. 33) No Could this be pre-excited atrial flutter Yes or antidromic tachycardia? 1, Fig. 2) or antitachycardia pacing Refer to cardiologist 21 22 COMMON PR ESENTATIONS T AB L E 4 . 1 Broad complex regular tachycardia: differential diagnosis Broad complex regular tachycardia and management Arrhythmia Comment Management Monomorphic ventricular tachycardia (Fig.
Underlying cardiac disease? g. history, Q waves on ECG)? g. exertional breathlessness, large cardiac shadow on chest X-ray, previous echocardiography)? – If so, avoid high-dose beta-blockers and ﬂecainide • Is there Wolff–Parkinson–White syndrome? This may cause: – AV re-entrant tachycardia (narrow complex, regular) (conduction forward through the AV node and back via the accessory pathway) – Fast conduction of atrial ﬁbrillation down the accessory pathway (broad complex, irregular) – Rarely, antidromic tachycardia (broad complex, regular) (conduction forward down the accessory pathway and back via the AV node) Continued Cardiac arrhythmias: general approach 20 COMMON PR ESENTATIONS Associated acute or chronic illness?
1) Yes No action needed No ECG consistent with atrial Yes fibrillation (AF)? 1) No Atrial fibrillation (AF) with bundle branch block or pre-excited AF (Fig. 1) QT prolongation before ventricular tachycardia (VT)? Yes No • Stop drugs which may prolong QT interval • Correct hypokalemia (p. 447) • Temporary pacing (p. 2) • If evidence of myocardial ischemia, manage as acute coronary syndrome (pp. 1 Broad complex irregular tachycardia: differential diagnosis and management Arrhythmia Comment Management Atrial ﬁbrillation with bundle branch block (Fig.