Wide complex rhythm and cardiac arrest

Abstract

m h p b w e e ( s t r. Peter Pang: Today’s case is that of a 54-year-old oman who presented to the Emergency Department ED) in respiratory distress. Paramedics were called for hortness of breath and weakness. At the scene the paient complained of worsening shortness of breath hroughout the day, increasing significantly over the past our, and generalized weakness over the past week. ccording to the paramedics, the patient denied chest, ack, or abdominal pain. There were no fevers, chills, ausea, vomiting or diarrhea. The past medical history ncluded depression and a pulmonary embolism (PE). ital signs in the field were: blood pressure 104/60 mm g, heart rate 70 beats per minute (bpm), and respiratory ate 24 breaths per minute. During transport, the patient ecame increasingly short of breath and lethargic. Upon rrival in the ED, the patient deteriorated rapidly. She ad clear lungs, a slow regular heart rate, soft abdomen, nd bilateral lower extremity edema. The patient was ethargic, minimally responsive to verbal stimuli, and oving all four extremities. During transport from the aramedics’ gurney to the hospital stretcher, the patient’s espiratory effort ceased, and no pulses were palpable. Dr. Eric Nadel: Are there any questions about the nitial presentation? Dr. Emily Senecal: You mentioned the past medical istory included pulmonary embolism and depression. as the patient taking any medications? Were any pill ottles found in the house? Was there any family mem-