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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
Affiliations- Institute of Public Health, Faculty of Public Health, Medical University of Silesia in Katowice
- Voivodship Specialist Hospital No. 3 in Rybnik, Emergency Room
- Voivodship Rescue Service in Katowice
- Department of Emergency Medicine and Disasters, Medical University of Bialystok
- Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
- Lviv National Medical University named after Danylo Halytsky, Ukraine
- Attorney's Office Knapek, Rybczyński, Szmit and Partners
- Department of Emergency Medicine, Medical University of Warsaw
- Department of Histology, Medical University of Gdansk, Gdansk
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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.
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 arrest, cardiac dysrhythmia, emergency medicine, emergency medical service, ventricular tachycardia, VT, aggression
About this articleTitle
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
Journal
Disaster and Emergency Medicine Journal
Issue
Article type
Case report
Pages
167-172
Published online
2018-03-13
Page views
855
Article views/downloads
760
DOI
Bibliographic record
Disaster Emerg Med J 2017;2(4):167-172.
Keywords
cardiac arrest
cardiac dysrhythmia
emergency medicine
emergency medical service
ventricular tachycardia
VT
aggression
Authors
Tomasz Kulpok- Baginski
Klaudiusz Nadolny
Jerzy Robert Ladny
Sergiy Fedorov
Nataliya Izhytska
Anna Rej-Kietla
Lukasz Szarpak
Daniel Slezak
References (10)- Zipes DP, Wellens HJ. Sudden cardiac death. Circulation. 1998; 98(21): 2334–2351.
- Trusz-Gluza M, Bednarkiewicz Z, Krupienicz A, et al. Częstoskurcz komorowy — podziały, mechanizmy, sposoby rozpoznawania i prognozowania [Ventricular tachycardia – divisions, mechanisms, ways of diagnosis and prognosis]. ESS. 1994; 1: 6.
- Opolski G. Kardiologia – kompendium. PZWL, Warszawa 2016.
- Pytkowsk M. Podstawy EKG, zaburzenia automatyzmu i przewodzenia, tachyarytmie. Medical Tribune Polska, Warszawa 2016.
- German LD, Packer DL, Bardy GH, et al. Ventricular tachycardia induced by atrial stimulation in patients without symptomatic cardiac disease. Am J Cardiol. 1983; 52(10): 1202–1207.
- Trusz-Gluza M, Bednarkiewicz Z, Krupienicz A, et al. Specyfika częstoskurczu komorowego w zależności od schorzenia podstawowego [Specificity of ventricular tachycardia depending on the basic disease]. ESS. 1999; 3: 80.
- Dąbrowska B, Dąbrowski A. Podręcznik elektrokardiografii. PZWL, Warszawa 1999: 105–107.
- https://www.slideshare.net/Firedemon13/cardiac-conduction-system (06.10.2017).
- The Regulation of the Minister of Health of 20 April 2016, item 587, on medical rescue operations and health services other than rescue operations which may be provided by the paramedic.
- Jankowski M, Cebula G. Resuscytacja krążeniowo-oddechowa według wytycznych European Resuscitation Council 2015:część IV: opieka poresuscytacyjna. Med Prakt. 2016; 4: 16–35.