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CAUTION: THESE NOTES CONTAIN SPOILERS!!!
Case Introduction
You are working a shift at EM Clerkshift General when you are called to the resuscitation bay to see an elderly patient with unstable vitals brought in by EMS.
Initial Vitals
- Temp 98.0F
- HR 43
- RR 18
- BP 60/40
- O2 98%
Critical Actions
- Diagnose the etiology for the bradycardia (BB overdose)
- Administer Atropine
- Administer Glucagon
- Administer Epinephrine drip
- Attempt transcutaneous/transvenous pacing
- Administer high-dose Insulin therapy
Final Diagnosis
Beta Blocker Overdose
Tips and Tricks
- Keep in mind the broad differential for severe bradycardia – ischemia, ingestion, electrolyte abnormalities, intrinsic arrhythmia/heart block, hypothyroidism, hypothermia, hypoglycemia, hypoxia, increased intracranial pressure, neurogenic shock.
Further Reading