Scenario
An 82 year old man is brought to the emergency department following a brief collapse at home. He has a history of chronic renal failure and hypertension. His medications include an angiotensin converting enzyme inhibiting agent (ACEI), frusemide and metoprolol. He has no traumatic injuries from this episode.
Examination reveals:
His ECG demonstrates third degree atrioventricular block.
Question
Describe your management (100%)
Answer
FACEM SAQ Exam 2010.1 – Question 6
- The overall pass rate for this question was 45/70 (64.3%)
- Pass Criteria
- Recognition of shock
- Consideration of all of:
- IV Fluids
- Atropine
- Pacing (transcutaneous or transvenous)
- Use of inotropes/chronotropes
- Discussion of disposition to appropriately monitored bed.
- Better answers described above in context of possible causes of collapse in this patient – B-blocker toxicity, ACS, electrolyte imbalance, head injury, hypothermia.
- Features of unsuccessful answers
- Failure to recognise shock
- Failure to take steps to correct rate
ACEM Fellowship Short Answer Questions (SAQ)
About Mike Cadogan
