Did you ever find it time consuming and confusing to answer the multiple choice questions about the "what will you do next" questions for different heart rhythm disorders?
Well, we did too. So, we are going to post some algorithms in subsequent posts, which will make it easier and save you some time in the preparation. They will guide your thoughts during those timed multiple choice questions.
Ventricular Tachycardia: It's a type of ventricular arrhythmia. The EKG is a must have diagnostic test. Look for wide-QRS-complexes. If the EKG is inconclusive--> telemetry monitoring should be done. If the questions asks, what is the most accurate test to diagnose this patient with V.Tach--> its Electrophysiologic studies.
Now, read very carefully the last line of the question as to what the question is demanding; it could be the next step in management or the test for a definite diagnosis.
The next (VERY IMPORTANT) step is to look at the vital signs and understand if the patient is hemodynamically unstable
(LOOK FOR :
*IS THE B.P. LOW?
*IS THERE CHEST PAIN?
*CHECK THE Respiratory Rate- does the patient complain of shortness of breath/dyspnea,
*LOOK FOR HIS MENTAL STATUS- is the patient confused/has altered mental status? *LOOK FOR SIGNS/SYMPTOMS OF CHF.
If any of these are present--categorize the patient as Hemodynamically Unstable.
And then, follow the chart below for management questions.
Well, we did too. So, we are going to post some algorithms in subsequent posts, which will make it easier and save you some time in the preparation. They will guide your thoughts during those timed multiple choice questions.
Ventricular Tachycardia: It's a type of ventricular arrhythmia. The EKG is a must have diagnostic test. Look for wide-QRS-complexes. If the EKG is inconclusive--> telemetry monitoring should be done. If the questions asks, what is the most accurate test to diagnose this patient with V.Tach--> its Electrophysiologic studies.
Now, read very carefully the last line of the question as to what the question is demanding; it could be the next step in management or the test for a definite diagnosis.
The next (VERY IMPORTANT) step is to look at the vital signs and understand if the patient is hemodynamically unstable
(LOOK FOR :
*IS THE B.P. LOW?
*IS THERE CHEST PAIN?
*CHECK THE Respiratory Rate- does the patient complain of shortness of breath/dyspnea,
*LOOK FOR HIS MENTAL STATUS- is the patient confused/has altered mental status? *LOOK FOR SIGNS/SYMPTOMS OF CHF.
If any of these are present--categorize the patient as Hemodynamically Unstable.
And then, follow the chart below for management questions.
- Vikramjeet Kakade & Rajavee Panchal
Thank you. This is quite helpful.
ReplyDeleteI am glad it helped:)
DeleteRajavee;
ReplyDeleteThank you for the post , but the chart is too small to properly read.