You are transporting a patient who is having wild changes in his heart rate, an irregular R-R interval, and a history of taking Lanoxin. The patient is now becoming pale, cool, and clammy, with an MAP of 60. You should:
A) not worry, as this is a normal presentation.
B) begin TCP and consider a catecholamine infusion.
C) infuse a calcium channel blocker.
D) start an amiodarone drip.

Question

Quizplus · Accepted Answer

The patient is experiencing signs of significant cardiac instability, likely due to the Lanoxin toxicity. The irregular R-R interval suggests atrial fibrillation, which can be treated with transcutaneous pacing (TCP) to control the heart rate. A catecholamine infusion (e.g. dopamine, epinephrine) may also be necessary to support blood pressure and cardiac output. Infusing a calcium channel blocker or starting an amiodarone drip may worsen the patient's condition by further suppressing cardiac function.

You Are Transporting a Patient Who Is Having Wild Changes