An older, but sprightly female is brought to the ED after developing multiple episodes of vomiting. Her husband had been vomiting as well but his symptoms had settled after a few hours.
She has minimal clinical history apart from hypertension for which she takes two separate agents.
The prompt to attend the ED came after the lady passed out for about 30 seconds following an episode of vomiting.
Her vitals are normal and her ECG is shown below.
- I’m no Amal Mattu but that looks like pretty standard A Fib to me…
While you are enquiring about any further past medical history she becomes nauseated again and begins to retch. The retching quickly stops but she is no longer able to answer your questions. While you’re becoming increasingly frustrated with your patients reluctance to engage in conversation, the nurse shoves you out of the way and commences CPR.
Following about 30 secs of CPR and the patient pushes the nurse away. You review the telemetry reading from the monitor and it is shown below.