12.01.2020 - By Zack Olson, MD and Michael Estephan, MD
CAUTION: THESE NOTES CONTAIN SPOILERS!!!
Case Introduction
You are sitting at your computer on an otherwise beautiful Friday afternoon when a mother brings her 16 year old son to the ED with chief complaint of allergic reaction.
Initial Vitals
* Temp 98.7* HR 155* RR 28* BP 125/85* O2 99%
Critical Actions
* Interpret ECG * Interview patient alone (and identify trigger)* Perform vagal maneuver* Administer Adenosine* Discharge patient
Final Diagnosis
Supraventricular Tachycardia
Tips and Tricks
* Interview pediatric patients without family members in the patient’s room* Escort family out of patient room during invasive procedures* Ask about / rule out potential triggers (caffeine use, drugs, ischemia, electrolyte abnormalities, etc)
Further Reading
The REVERT Trial (RebelEM)