A COPY OF THE TACHY RESUS SCENARIO WE USE GOOD FOR PRACTICE USE IN CONJUNCTION WITH THE ACLS TACHY RESUS ALGORITHM

1. tachy resus scenario casualty
13 July 2015
Tachycardia case scenario
YOUR PT IS A 40 YR OLD INDIAN MALE WITH A VERY HIGH BMI ( AND A MAGNIFICENT
BEARD AND AN UNNATURAL LOVE OF CARPAL BONES)
HE PRESENTS AS HE HAS SEVERE PALPITATIONS AND IS FEELING GENERALLY UNWELL,
HOWEVER HE IS NOT IN DISTRESS WITH NO PAIN, A NORMAL BP,AND A GCS 15/15. YOU ASSESS
HIM IN THE RESUS AREA AS YOU ARE CONCERNED BECAUSE HIS HEART RATE SEEMS VERY
HIGH FROM THE TRIAGE AREA
THIS IS CONFIRMED WHEN YOU SET UP YOUR MONITORS , AS YOUR THREE LEAD ECG
SHOWS THE FFG TRACING
A NARROW COMPLEX TACHYCARDIA
WHAT DO YOU DO?
HINTS: IMMEDIATELY GRAB THE TACHY ALGORITHM
IS YOUR PT STABLE OR UNSTABLE
ARE THERE EXTRINSIC FACTORS EG. HYPOVOLEAMIA,FEVER ETC.
CONTINUE ACCORDING TO THE ALGORITHM
YOU USE ADENOSINE AND THIS APPEARS

2. tachy resus scenario casualty
13 July 2015
YOUR PT SHOWED GOOD RESPONSE BUT YOU NOTICE A CHANGE ON YOUR ECG
LEADS
WIDE COMPLEX SVT
HE IS STILL QUITE STABLE WITH AGOOD BP, GCS15/15, NO PAIN NO SIGNS OF HEART
FAILURE OR SHOCK
WHAT DO YOU DO ?
HINTS: YOUVE ALREADY GIVEN ADENOSINE WHAT IS YOUR FOLLOW UP DOSAGE
SHOULD WE START AN INFUSION WITHOUT EXPERT CONSULTATION
SHOULD YOU RUSH TO CARDIOVERT
GOOD WORK EVERYBODY, YOUR PT HAS BEEN SUCCESSFULLY TRANSFERRED TO ICU
IN A STABLE CONDITION
GOOD WORK FFG THE ALGORITHM

3. tachy resus scenario casualty
13 July 2015
UNFORTUNATELY JUST AS HE LEAVES HIS IDENTICAL TWIN BROTHER IS BROUGHT IN
WITH A HISTORY OF 2HRS SEVERE CHEST PAIN, HIS GCS IS E=2 M=4 V=4 =10/15
HIS BP IS 85/50
WIDE SPREAD CREPS ARE HEARD BILAT
AND HIS CAP REFILL IS >4SECS
YOU SET UP YOUR MONITOR AND THIS PATTERN APPEARS
WIDE COMPLEX MONOMORPHIC VTAC
HINTS : HE DOES HAVE A PULSE
WOULD YOU CONSIDER ADENOSINE
WHAT INITIAL CHARGE WOULD YOU USE
YOU SET YOUR MACHINE TO PACE AND WILL SEE THIS

4. tachy resus scenario casualty
13 July 2015
OR THIS
NOW WHAT DO YOU DO?
CHARGE AND DISCHARGE YOUR DEFIB
WHAT HAPPENS
WHY THE DELAY IN THE DISCHARGE OF CURRENT
AND NOW THIS APPEARS!!!!!!!!!!!
TORSADES DE POINTES
WHAT DO YOU DO?

5. tachy resus scenario casualty
13 July 2015
GOOD WORK
THIS NOW APPEARS ON YOUR ECG STRIP
NORMAL SINUS RHYTHYM
WHAT DO YOU DO NOW
GOOD WORK EVERYBODY
TACHYCARDIAS WILL NOT CAUSE SWEATING AND LOOSE BOWELS ANYMORE!!!!

6. tachy resus scenario casualty
13 July 2015