This entry was posted on Wednesday, April 3rd, 2013 at 11:03 am and is filed under .
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2nd degree block. This should be treated immediatly.
The baseline wander makes it a little tough to see the p waves. I’m guessing 3rd Degree AV block, but could be a Wenkeboch as well. No ST elevation. T waves are definitely flattened though.
Either way, if the BP is stable and the patient is mentating well, the EKG alone doesn’t warrant any treatment of the rhythm (i.e. no pacing or atropine for a bradycardia that isnt putting the patient in extremis). I’m a paramedic so I may be stepping outside my pay grade, but I’d definitely want to see the patient’s K. If hypokalemia isn’t the answer, maybe an overdose on beta blockers or other antihypertensive/antidysrhythmic. Last thought, it may just be normal progression of some pathology affecting SA node that her physician has elected to wait to place pacemaker, check her old EKGs and refer to Cardiology.
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