THE ISSUE OF AGGRESSION IN PATIENTS WITH VENTRICULAR TACHYCARDIA WITH PULSE AND A SHORT EPISODE OF CARDIAC ARREST — A CASE OF A 68-YEAR-OLD MALE
Abstract
INTRODUCTION: Ventricular tachycardia (VT) is a life-threatening event. The role of the medical rescue team is to diagnose this disorder on the basis of resuscitation guidelines and general recommendations concerning ECG diagnoses. Patients with ventricular tachycardia, as a result of cerebral hypoxia, may react with aggression. In such situations, taking one’s medical history, conducting a physical examination or attempting emergency rescue operations may become difficult, or even impossible.
OBJECTIVE: The objective of the paper is to demonstrate the issue of unintentional aggression that may occur in patients with ventricular tachycardia (VT) with a high heart rate and a short episode of cardiac arrest (CA), and the impact of such a disorder on attempted medical rescue operations.
MATERIAL AND METHODS: The analysis of the case study was performed on the basis of medical documentation, i.e. an emergency dispatch order and an emergency medical services form.
CASE DESCRIPTION: A medical emergency unit stationed at one of the substations in Łódź Province, 27 km away from a multi-disciplinary hospital, received a call from a medical dispatcher. The person calling emergency services requested the urgent arrival of an ambulance for her husband, who had suddenly passed out and was now lying on the kitchen floor showing no signs of life. In the course of the ambulance’s arrival at the location, the patient’s wife urged the ambulance to arrive soon, on account of her husband’s aggressive behaviour.
CONCLUSIONS: Cardiac dysrhythmia and particularly ventricular tachycardia (VT) may constitute a serious health issue for the patient. The clinical picture may also vary across patients. An analysis of the case study demonstrates that medical personnel must be prepared to handle unconventional scenarios. The article shows that the procedure of cardioversion may be the only right choice when handling a patient with an unstable tachycardia.
Keywords: cardiac arrestcardiac dysrhythmiaemergency medicineemergency medical serviceventricular tachycardiaVTaggression
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