old one was more than 90 days old........time flies

no ekg this week, but from a hemodynamic standpoint it was an educational night.

left work yesterday morning and my patient had a "normal arterial line waveform" k. pt was on dopamine for a MAP>65 -- maxed out at 25mkg/kg/min

she ended up on vasopressin as well as dopa. yesterday afternoon she had a cardiac "event" aka she nearly coded

i arrive last night to find a waveform like this:



something was WRONG, but I havent seen a waveform like this before, and one of the HO's wasn't impressed/concerned by it(whatever)

she was hooked up to the LIDCO monitoring system, but we didnt really trust the data it was giving

around 2200 hours her CO suddenly dropped to 1.5 with a cardiac index of .94...... omg WTF she was started on 2.5 of dobutamine. CO improved, but my art line waveform still looked like shit.

so here is the challenge.......... without looking at that website....... tell me why that waveform looks like it does, and what can be done to treat it?

5/17/2008 8:15:04 AM

looks like the P wave caught teh ghey, and led to a premature ejaculation of the R wave.

or the sinoGAYtrial node is getting too excited, and not giving the AV node enough time to go off.

am i doin it right?

5/17/2008 8:42:27 AM

Quote :

"yeah i mean i could make a ton of threads about shit i do at work that wouldnt really mean anything to anyone else except maybe a select few and make me sound as pretentious as hell a good bit of us could but we dont"

5/17/2008 9:00:05 AM

did you check the anus? there was probably something wrong with the anus.

5/17/2008 9:23:55 AM

Quote :

"did you check the anus? there was probably something wrong with the anus."

5/17/2008 11:24:31 AM

i want a grill cook from like applebees to come make threads like this

customer ordered "smothered chicken with no peppers" --- hmm never made that before... flip through rolodex... oook smothered chicken here we go, cup of tomato chunks per pound. CHX nearly coded on broiil side cause tommy was out back burning another J

5/17/2008 11:39:50 AM

^ haha

5/17/2008 1:24:52 PM

Quote :

"yeah i mean i could make a ton of threads about shit i do at work that wouldnt really mean anything to anyone else except maybe a select few and make me sound as pretentious as hell a good bit of us could but we dont"

QFT

5/17/2008 1:55:52 PM

Quote :

"did you check the anus? there was probably something wrong with the anus."

5/17/2008 2:26:51 PM