ABSTRACT

This chapter provides case studies that are examples of various cardiac dysrhythmias. Correct interpretation is the first step but, more importantly, remember that one need to treat the patient, not the monitor. For many abnormal rhythms one will have time to evaluate the overall situation and obtain assistance or consultation. For others (e.g. ventricular fibrillation, pulseless ventricular tachycardia) one must act quickly and decisively with prompt defibrillation. Atrial tachycardias for paroxysmal supraventricular tachycardia (PSVT), one may try vagal manuevers or adenosine (6 mg) IV push. Premature ventricular contraction (PVC) Occasional PVCs in the asymptomatic patient without suspected heart disease do not require treatment. Asystole The straight line on an ECG indicates the complete absence of ventricular activity. Pulseless electrical activity (PEA) (previously termed electromechanical dissociation or EMD) is present when the ECG shows activity but there is no detectable pulse and the patient is unresponsive. The priorities in caring for cardiac arrest concern oxygenation and circulation.