And then there was this other patient.

So next shift after the Heart Block pt we're tasked to a person fitting?!

Pt sitting on a kitchen chair,
Conscious, alert (if not a little 'space cadet' with us),
BP about ten mmHg lower than you would expect,
BGL normal,
Describes an almost out of body experience - vertigo, knowing the body was shake/twitching, was aware of heart beat and sweating.
No Incontinence or LOC,
Pulse irregularly irregular?????

Why don't we put the dots on and have a look and what's that we see with the ol' Zoll Defib that gets bounced around day after day in the back of the truck,

No P waves - AF, but hang on
That looks like Atrial Flutter on the long R-R Interval,
And is that a Bundle Branch Block as well?

Ching Ching, Congratulations you've won a trip to Hospital.

The pt had been sitting talking to their partner enjoying a beer or two and a spiff, a roach, a bit of Mary Jane,,,, Cannabis.

No current meds,
Only past med history that of IVDU like thirty years ago, been clean for twenty.
Father died early (two - three years younger than pt is now!) of IHD or similar.

So Hypoxic Seizure from the combination of the three cardiac issues,
Transport,
Oxygen,
Monitor,
Acetylsalicylic Acid (or Aspirin if I have to say it),
Re-assure pt and partner

After all,

We're Professionals in Control


Be careful out there and I'll see you at the Big One.

Taz