tag:blogger.com,1999:blog-4505990433916682663.post3208543203315196071..comments2024-03-13T02:04:31.476-04:00Comments on Paramedicine 101: Strip Tease 13: AnswerAdam Thompson, EMT-Phttp://www.blogger.com/profile/18107359165856983910noreply@blogger.comBlogger7125tag:blogger.com,1999:blog-4505990433916682663.post-61447289655422394862010-08-13T08:21:00.952-04:002010-08-13T08:21:00.952-04:00Adam -
I am convinced that stupid little ambiguo...Adam - <br /><br />I am convinced that stupid little ambiguous comments from anonymous bloggers like "I am afraid I do not know" or "Good point" or "Thank you this is useful" are "pings" from SPAM robots to see if they can target your blog.<br /><br />TomTom Bhttps://www.blogger.com/profile/18291404904437933272noreply@blogger.comtag:blogger.com,1999:blog-4505990433916682663.post-58398018758468085212010-08-11T22:20:34.284-04:002010-08-11T22:20:34.284-04:00Don't know what?Don't know what?Adam Thompson, EMT-Phttps://www.blogger.com/profile/18107359165856983910noreply@blogger.comtag:blogger.com,1999:blog-4505990433916682663.post-48399647868787762872010-08-11T21:19:46.848-04:002010-08-11T21:19:46.848-04:00I am afraid, that I do not know.I am afraid, that I do not know.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4505990433916682663.post-89777202388978564962009-08-09T06:33:50.301-04:002009-08-09T06:33:50.301-04:00RM,
That is a good point to make. I can't b...RM, <br /><br />That is a good point to make. I can't believe I didn't mention this. Whatever the rhythm is, the treatment for the high grade AVB is the same. The argument is just semantics.Adam Thompson, EMT-Phttps://www.blogger.com/profile/18107359165856983910noreply@blogger.comtag:blogger.com,1999:blog-4505990433916682663.post-61929071927793906022009-08-08T23:48:56.751-04:002009-08-08T23:48:56.751-04:00I disagree with the approach as you present it. Th...I disagree with the approach as you present it. The PR interval is the important measurement, as you point out. <br /><br />Suppose that the P-P interval is irregular, does that tell us anything? Many ECGs have P-P variability, but what does it mean? It is normal <b>and</b> healthy for the heart rate to vary with respirations. This does not happen without P-P variability.<br /><br />Regardless of whether there is R-R variability, the PR interval is what matters.<br /><br />I confess that I did not pay close enough attention to the PR interval to pick up on the variation. It is there, but superficially appears to be a regular, for the conducted P waves, PR interval. Excellent example of an easy mistake to make.<br /><br />Regardless of the different intervals and regardless of the final diagnosis of the rhythm, we should base our treatment on the condition of the patient. Bradycardia is an important algorithm to be familiar with. <br /><br />These patients tend to be closer to death than the tachycardia patients. The more normal response to stress, the more healthy response to stress, is tachycardia - not bradycardia. We should be prepared to become very aggressive very quickly, if indicated. Bradycardia seems to be mistreated much more often than tachycardia.Rogue Medichttps://www.blogger.com/profile/07598646309630074992noreply@blogger.comtag:blogger.com,1999:blog-4505990433916682663.post-39193119711972652622009-08-08T23:20:00.426-04:002009-08-08T23:20:00.426-04:00C.Watford,
That is a great observation. The QRSd...C.Watford,<br /><br />That is a great observation. The QRSd actually is about 120 ms from my calculations. It appears quite narrower on the computer. <br /><br />It isn't that wide though and this may be due to a few factors. <br /><br />- It may be that this is a degenerating Mobitz 2 as stated.<br /><br />- Or, the block may be just just above the bundle of his. With a block proximal the bundle branches you may have less obvious aberrancy. Those trifascicular CHBs are pretty wide.<br /><br />There are many examples of seemingly narrow CHBs on the web. It is less common.Adam Thompson, EMT-Phttps://www.blogger.com/profile/18107359165856983910noreply@blogger.comtag:blogger.com,1999:blog-4505990433916682663.post-40690460015741727272009-08-08T22:11:59.383-04:002009-08-08T22:11:59.383-04:00It seems odd that it would be narrow and disassoci...It seems odd that it would be narrow and disassociated, especially with how isochronic they appear to be. I guess I'm wondering why I wouldn't be seeing a wider QRSd or at least a faster junctional rhythm if narrow (40-60)?<br /><br />Also some slurring of the S-wave, right bundle problems too?Christopherhttps://www.blogger.com/profile/11415988855392944633noreply@blogger.com