Scenario
This 23 year old man complains of palpitations and dizziness. His blood pressure is 70/50.
Question
a. Describe the ECG. (50%) b. How would you manage this man. (50%)
Answer
FACEM VAQ Exam 2003.2 – Question 7
- Overall pass rate for this question was 42 / 82 (51.2%).
- An ECG showing a rapid, regular tachycardia with borderline QRS width is shown.
- Examiners felt that this was a good ECG demonstrating a problem that was important for an emergency physician to be able to interpret and manage.
- It was expected that the ECG description would include a synthesis and mention of the factors that could be used to differentiate VT from PSVT with aberrancy.
- Management was expected to include the use of cardioversion in this unstable patient.
- Extra points were given for treating any underlying causes. Failures occurred due to use of inappropriate therapies such as verapamil or an unstructured approach to the ECG with VT not included in the differential.
ACEM Fellowship Visual Aid Questions
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