Round 34 (Shortness of Breath / Bradycardia)

You are working at Clerkship General when you are called to see a 70 yo male who is presenting with shortness of breath.











Initial Vitals











* Temp 98.0* HR 36* RR 28* BP 80/35* O2 82%











Critical Actions











* Interpret ECG Correctly (3rd degree AV block)* Order a troponin* Perform and Describe transcutaneous pacing* Perform and Describe transvenous pacing* Treat NStemi (ASA, Heparin gtt, nitro if BP improved after pacing)











Further Reading











Complete Heart Block – EMDocs











Bradycardia – EMCrit