You are working at Clerkship General when you are called to see a 70 yo male who is presenting with shortness of breath.

Initial Vitals

  • Temp 98.0
  • HR 36
  • RR 28
  • BP 80/35
  • O2 82%

Critical Actions

  • Interpret ECG Correctly (3rd degree AV block)
  • Order a troponin
  • Perform and Describe transcutaneous pacing
  • Perform and Describe transvenous pacing
  • Treat NStemi (ASA, Heparin gtt, nitro if BP improved after pacing)

Further Reading

Complete Heart Block – EMDocs

Bradycardia – EMCrit