Evaluation and acute management of wide QRS complex tachycardia

ESC CardioMed ◽  
2018 ◽  
pp. 2256-2259
Author(s):  
Sei Iwai ◽  
Jason Jacobson
Keyword(s):  
Emergency Department ◽  
Ventricular Tachycardia ◽  
Supraventricular Tachycardia ◽  
Hospital Setting ◽  
Acute Management ◽  
Qrs Complex ◽  
Haemodynamic Stability ◽  
Clinical Challenge ◽  
Qrs Duration

Wide QRS complex tachycardia (WCT) is a common clinical challenge, and can present in a variety of settings, including the emergency department, in the in-hospital setting, during operations, and even in the outpatient arena. The proper, and timely, acute management of WCT is contingent on the proper evaluation and diagnosis of the tachycardia. WCT, an arrhythmia with a QRS duration of over 120 ms, at a rate of over 100 beats per minute, can be due to either supraventricular tachycardia with aberrant conduction or due to ventricular tachycardia. The management of these two entities can vary considerably, especially if the patient presents without significant haemodynamic stability.

Atrial Fibrillation and Other Cardiac Arrhythmias (DRAFT)

2018 ◽  
Author(s):  
Antoine Schneider ◽  
Rinaldo Bellomo
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Atrial Flutter ◽  
Supraventricular Tachycardia ◽  
Cardiac Arrhythmias ◽  
Older Patients ◽  
Hospital Setting ◽  
Rapid Response Team ◽  
Hospitalized Patients ◽  
Response Team

Cardiac arrhythmias are common in hospitalized patients, with their incidence increasing in older patients and those with comorbidities. Cardiac arrhythmias represent a trigger for approximately 10% of rapid response team (RRT) activations. Of those, atrial fibrillation (AF) is the most commonly observed. Other common cardiac arrhythmias in the in-hospital setting include supraventricular tachycardia, atrial flutter, ventricular tachycardia, and bradycardias. Members of the RRT should be skilled in the diagnosis and management of these common arrhythmias. This chapter presents an overview of cardiac arrhythmias that RRT members are likely to encounter, discussing their incidence and significance, as well as their immediate management.

Cardiac Arrhythmias – Part II:Broad Complex Tachycardia . . .

2005 ◽  
Vol 4 (1) ◽  
pp. 3-9
Author(s):  
Mark D O’Neill ◽  
◽  
D Wyn Davies ◽  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrhythmias ◽  
Ventricular Arrhythmias ◽  
Acute Management ◽  
Critical Importance ◽  
Diagnosis And Management ◽  
Clinical Challenge ◽  
Accident And Emergency ◽  
Accident And Emergency Department ◽  
Broad Complex

The acute management of the patient presenting with a broad complex tachycardia is a daunting clinical challenge. A broad complex tachycardia may be ventricular or supraventricular in origin and the ability to interpret correctly the 12-lead electrocardiogram is of critical importance in this differentiation. Broad complex tachycardia should be assumed to be ventricular in origin unless there is compelling clinical and electrocardiographic evidence to the contrary. This article focuses on the immediate diagnosis and management of broad complex tachycardia. In view of the broadening indications for implantation of cardioverterdefibrillator devices (ICD) in the management of ventricular arrhythmias, an approach to the ICD patient presenting to the accident and emergency department with recurrent device discharges is discussed.

scholarly journals Differential Diagnosis of Wide QRS Tachycardias

2020 ◽  
Vol 9 (3) ◽  
pp. 155-160
Author(s):  
Demosthenes G Katritsis ◽  
Josep Brugada
Keyword(s):  
Differential Diagnosis ◽  
Ventricular Tachycardia ◽  
Clinical Practice ◽  
Supraventricular Tachycardia ◽  
Correct Diagnosis ◽  
Diagnostic Methods ◽  
Qrs Duration

In this article, the authors discuss the differential diagnostic methods used in clinical practice to identify types of wide QRS tachycardias (QRS duration >120 ms). A correct diagnosis is critical to management, as misdiagnosis and the administration of drugs usually utilised for supraventricular tachycardia can be harmful for patients with ventricular tachycardia.

scholarly journals A Structured Curriculum for Interprofessional Training of Emergency Medicine Interns

2019 ◽  
Vol 21 (1) ◽  
pp. 149-151 ◽  
Author(s):  
Ashley Rider ◽  
Tiffany Anaebere ◽  
Mariko Nomura ◽  
David Duong ◽  
Charlotte Wills
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Interprofessional Education ◽  
Hospital Setting ◽  
Scope Of Practice ◽  
Registered Nursing ◽  
Interprofessional Training ◽  
Before And After ◽  
Team Based Care ◽  
Improve Health

Interprofessional education (IPE) has been shown to improve health outcomes and patient satisfaction. IPE is now represented in the Accreditation Council for Graduate Medical Education’s emergency medicine (EM) milestones given the team-based nature of EM. The Highland Allied Health Rotation Program (H-AHRP) was developed by residents to enhance and standardize IPE for EM residents in a single hospital setting. H-AHRP was incorporated into the orientation month for interns starting in the summer of 2016. EM interns were paired with emergency department preceptors in registered nursing (RN), respiratory therapy (RT), pharmacy (PH), laboratory (LAB), and social work (SW) in either a four-hour shadowing experience (RN, RT, PH) or lecture-based overview (LAB, SW). We conducted a survey before and after the program. Overall, the EM interns reported an improved understanding of the scope of practice and day-to-day logistics after working with the preceptors. They found the program helpful to their future as physicians and would recommend it to other residencies. The H-AHRP program allows for the early incorporation of IPE into EM training, enhances interns’ understanding of both the scope and logistics of their colleagues, and is a well-received effort at improving team-based care.

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