ECG Challenge: The path 'more' traveled

EMS is called to a hardware store for a 59-year-old male with palpitations


Here's an interesting case submitted by Adam Thompson from Paramedicine 101. Some changes have been made to preserve patient confidentiality. EMS is called to a hardware store for a 59-year-old male with palpitations.

On arrival the patient is found sitting in a chair in the storeroom. He appears anxious. Skin is pink, warm and moist. He states that this has "happened before" but it's "been a while."

The patient is a poor historian. He states that he's seen a doctor for palpitations before and they "wanted to some kind of procedure but I said forget it!"

Medications:

None

Vital signs:

RR: 14
Pulse: Extremely rapid and irregular
NIBP: 138/91
SpO2: Does not register

The patient denies chest pain or shortness of breath.

Breath sounds are clear bilaterally.

The cardiac monitor is applied.


How would you treat this patient and why?

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