I have been working as a Paramedic now for...approximately 3 weeks.
I have been thinking like a Paramedic for much longer.
For Paramedic Bag-of-Tricks, I have administered exactly 150 mcg of fentanyl.
My first 12 lead interpretation as a Paramedic consisted of a diabetic chest pain patient....
How is A. fib with inconsistent aberrancy sound?
Go figure that it couldn't be sinus, or STEMI, or ANYTHING straight forward. No, it has to be a pt. with some narrow QRS once and a while, then wide RBBB-like QRS for a little while.
It wasn't runs of V-Tach, because it stated in a rate of the 60-70 bpm.
Luckily, when we got to the ED, the Tech already had an old copy of the Patient's EKG, and it looked the exact same.
Update (8/24/1): More information(or guessing and conjecture!) on Chest Pain patient here
What you're describing sounds like Ashman's Phenomenon, which is very common in atrial fibrillation.
ReplyDeleteBasically, if you've got a long R-R, then a short R-R the complex may be conducted with RBBB.
Pretty neat huh?
The more I look into this Ashman's Phenomenon, the more I think you are right...
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