#SimBlog: Please, Just Go Faster!!

““72-year-old male presented to the ED from his GP as he was feeling very SOB. His GP did an ECG (shown below). He’s quickly moved into the ER.””

— Clinical Findings: No Adverse features. Well.

View fullsize

Observations

A: Spontaneous and self-ventilation

B: RR 18, Sats 99% Air

C: HR 34 BP 103/95

D: GCS 15/15

E: Temp 36.7°C

Why We Simulated?

Bradycardias can scare people – especially at the thought of having to do transcutaneous pacing (TCP). As this is a sim we haven’t done before, it was a good way for trainees to get to know the defibrillator and how it works.

Learning Outcomes

1. Always ask for help

2. How to use the defibrillator to pace

3. Atropine doesn’t work in Complete Heart Block

Positive Feedback

• Recognition of bradycardia and consideration for atropine

• Don’t be afraid to do TCP

• TCP does hurt! Remember to consider light sedation and analgesia

Further Reading:

• UHL: Management of Bradycardia (Local Guideline)
• RCEM Learning: Bradycardias (Module)