Round 21 (Drowning)

Summary: <br> CAUTION: THESE NOTES CONTAIN SPOILERS!!!<br> <br> <br> <br> Case Introduction<br> <br> <br> <br> You are working a shift at EM Clerkship General when EMS calls you on the radio… “Hey doc we’re bringing a young female who drowned in a pool ETA 1 minute”. <br> <br> <br> <br> Initial Vitals<br> <br> <br> <br> * Temp 95.0F* HR 55* RR 5-6* BP 110/82* O2 90%<br> <br> <br> <br> Critical Actions<br> <br> <br> <br> * Evaluate for traumatic injury (and/or place C-Collar)* Intubate the patient* Identify Long QT Syndrome on ECG* Treat Pulseless Polymorphic VTach with defibrillation and IV magnesium* Treat Polymorphic VTach (pulse present) with overdrive pacing (transcutaneous pacing or isoproterenol) <br> <br> <br> <br> Further Reading<br> <br> <br> <br> <a href="https://emcrit.org/ibcc/tdp/#:~:text=Polymorphic%20ventricular%20tachycardia,actually%20not%20the%20same%20thing.">Torsades de Pointes – EMCrit</a><br>