Ride the lightning
64 year old female calls EMS for acute onset of shortness of breath that began three hours prior. Upon arrival she was alert oriented times four, tachypneic, and anxious.
Patient reported she’s had three episodes like this prior. Reported she’s received dilt and adenosine in the past. However, she is unable to recall if she had history of SVT or A-fib. But was scheduled to for an ablation soon. No other pertinent medical history.
Vitals 95/50, R:24 SPO2: 98%, HR: 195-200.
RX: carvedilol.
Vasovagal maneuvers unsuccessful. Patient was given 2 mg of Versed for sedation and fluid bonus of lactated ringers. Synchronized cardioverted at 100j successfully.
Other than the discomfort from cardio-version, patient reported overall relief of everything else. . Post vital signs: HR: 128, Bp: 136/75, SPO2: 98% R:22. Patient transported without incident to local hospital.