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<\/a><\/p>\nFirst Glance:<\/strong><\/p>\n From across the room it looks like a huge mess of artifact.<\/p>\n Discussion:<\/strong><\/p>\n Let’s say you’re called to the bed for a rapid response. Your patient is unconscious. You look at the monitor and it looks like this. The tele monitor is screaming “VF! VF!”.<\/p>\n The RN hands you the paddles. Do you shock them?<\/p>\n Nope. You could look closely at the choppy EKG lead and see there is probably some regular spiky stuff tracking through consistent with QRS complexes on top of a movement or loose lead artifact, but why guess? What tells you this patient is NOT in VF right now?<\/p>\n Look at that beautiful lower trace. That ‘pleth’ is the Sp02 trace, and here it is clearly pulsatile. Pulsatile blood all the way out in the capillary beds where the pulse ox probe is definitely<\/em> rules out VF, and suggests a pretty decent BP all things considered. Even if you don’t trust the number, you can’t fake a Sp02 waveform like this. This person has a pulse. Period. Whether or not you can feel it with your shaking hands.<\/p>\n Here is the rest of the strip. When the artifact cools off we can see lovely chubby P waves. Clearly sinus. Final Impression?<\/strong><\/p>\n Sinus rhythm @ ~80 bpm<\/p>\n Management implications:<\/strong><\/p>\n don’t shock her.<\/p>\n \u00a0The Take-home Point:<\/strong><\/p>\n The pulse ox waveform definitively proves a pulse, and implies a systolic pressure sufficient to perfuse the brain in most patients. It isn’t useful in most code situations because most code patients do not have sufficient peripheral perfusion for the oximeter to actually read whether there is a pulse or not, or there is too much movement artifact to get a clean SpO2 trace, but at least it can ‘rule-in’ a pulse in some patients.<\/p>\n <\/p>\n <\/p>\n sinus rhythm First Glance: From across the room it looks like a huge mess of artifact. Discussion: Let’s say you’re called to the bed for a rapid response. Your patient is unconscious. You look at the monitor and it looks like this. The tele monitor is screaming “VF! VF!”. The RN hands you the paddles. …read more<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[4],"class_list":["post-426","post","type-post","status-publish","format-standard","hentry","category-cases","tag-1star"],"_links":{"self":[{"href":"https:\/\/www.electricant.net\/ekg\/wp-json\/wp\/v2\/posts\/426","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.electricant.net\/ekg\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.electricant.net\/ekg\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.electricant.net\/ekg\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.electricant.net\/ekg\/wp-json\/wp\/v2\/comments?post=426"}],"version-history":[{"count":7,"href":"https:\/\/www.electricant.net\/ekg\/wp-json\/wp\/v2\/posts\/426\/revisions"}],"predecessor-version":[{"id":428,"href":"https:\/\/www.electricant.net\/ekg\/wp-json\/wp\/v2\/posts\/426\/revisions\/428"}],"wp:attachment":[{"href":"https:\/\/www.electricant.net\/ekg\/wp-json\/wp\/v2\/media?parent=426"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.electricant.net\/ekg\/wp-json\/wp\/v2\/categories?post=426"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.electricant.net\/ekg\/wp-json\/wp\/v2\/tags?post=426"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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\n<\/a><\/p>\n<\/a>One star strip. Students should identify the rhythm correctly.<\/em><\/p>\n—> see the next strip<\/a><\/h1>\n","protected":false},"excerpt":{"rendered":"