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‘VT’ versus ‘SVT with aberrancy’.
The long list of VT "suggestive" ECG features is difficult to recall and apply in real time.
How can we simplify things?
Here is my ABCDE approach – five simple Qs to ask:
🧵👇
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Rob Buttner
507 posts
Rob Buttner
@rob_buttner
Author of the LITFL ECG Library | Adult/Paediatric Emergency Medicine Advanced Trainee | Adj Lecturer @monash_para | #ECG #FOAMed @LITFLblog
Australia เข้าร่วม Temmuz 2020
153 กำลังติดตาม6.8K ผู้ติดตาม
It’s been a while ⏰
Stay tuned. The team and I @LITFLblog are working on the biggest addition to the LITFL ECG Library to date.
#ActivateOrWait 🚨
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‘VT’ versus ‘SVT with aberrancy’.
The long list of VT "suggestive" ECG features is difficult to recall and apply in real time.
How can we simplify things?
Here is my ABCDE approach – five simple Qs to ask:
🧵👇
English
The ABCDE approach to VT v SVT
Came up with this last year when preparing an ECG talk for ICEM
Still my favourite piece of work giving a simplified, practical approach to a complex topic
LITFL@LITFLblog
VT or not VT…that is the question. Read the full article here 👉 bit.ly/3LJ7iXg
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Rob Buttner รีทวีตแล้ว
litfl.com/ecg-library/
This is by far the best website for anything ECG. Whenever I read something that is new to me I just look it up on their website and read their straight-to-the-point articles. Check it our for anybody interested (they even have 150 ECG questions!)
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QME
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@EM_RESUS @The_Nanashi_O @smithECGBlog @BrooksWalsh @AslangerE @PendellM @ekgpress @DidlakeDW @ecgrhythms @marioalrb84_a @brun_dav @MaruanCarlos @UlhasDr @Vadeboncoeur_Al @RobertHermanMD @cummingb1 @EMS12Lead I agree it’s not, but I immediately recognise the changes in I and aVL from knowing this pattern and am prompted to examine closer for other changes
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@rob_buttner @The_Nanashi_O @smithECGBlog @BrooksWalsh @AslangerE @PendellM @ekgpress @DidlakeDW @ecgrhythms @marioalrb84_a @brun_dav @MaruanCarlos @UlhasDr @Vadeboncoeur_Al @RobertHermanMD @cummingb1 @EMS12Lead Yes but not sure this is the “South African Flag” sign indicative of D1 Occlusion—I see High Lateral and Posterior Transmural ischemia here, consistent with Left Circumflex territory OMI.
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56/M with atypical chest pain. ECG recorded during pain.
@smithECGBlog @BrooksWalsh @AslangerE @PendellM @ekgpress @EM_RESUS @DidlakeDW @ecgrhythms @marioalrb84_a @brun_dav @MaruanCarlos @UlhasDr @Vadeboncoeur_Al @RobertHermanMD @cummingb1 @EMS12Lead #ECG
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@HansvanSchuppen @cliffreid Actually, in most small rural hospitals in Australia there is only one (or zero) anaesthetists on at any point in time.
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@cliffreid First, your question was on teamleadership. My opinion is B. Who can step in to perform interventions depends on local setting.
Second, the vast majority of settings will allow for a spare anesthesiologist to come in and help.
Finally, I notice some emotions in the responses
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If there is a cardiac arrest in the operating theatre, who should team lead?
A. Surgeon/proceduralist
B. Anaesthetist
C. Operating theatre nurse
D. EM or ICM physician
E. Don't care but blame Anaesthesia
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Rob Buttner รีทวีตแล้ว
Some great #pocus workshops still available - practical procedures with phantoms and live models, paediatrics and advanced US where you can learn high end US tips/advanced clinical integration from the experts. @broomedocs @rob_buttner @lukemphillips
Coda Change@codachange
Can’t make it to all four days of #Coda22? We have good news for you, Day-Only & Workshop-Only tickets have officially been released! Spots are filling up, with some workshops already sold out, so don’t wait to register: codachange.org/registration/
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10.8 million users...
From nearly 44,000 cities 🌆
In 245 countries 🌏
... in the last year alone.
The power of #FOAMed through @LITFLblog
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1) Any patient who is a representation or failed discharge from the emergency department
2) When I am asked to “quickly send someone home" from the waiting room or triage
3) When an experienced clinician asks for advice on a patient
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Knowing how to switch between system 1 and 2 thinking is one of the most important skills of an Emergency Clinician.
When do you choose to employ a System 2 approach?
Here are three situations for me. Comment with your own so we can improve our approach 👇🧵
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@rob_buttner Great the ABCDE pattern , I suggest to Add letter F .. for very fast rate is going with SVT with abberency
thanks
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By popular demand, the ABCDE approach is now an established part of the @LITFLblog ECG Library.
I've also added an optional F -- check out the post to learn more.
litfl.com/vt-versus-svt-…
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The ABCDE of VT by @rob_buttner
The most memorable education on distinguishing VT from SVT with aberrancy that we’ve come across. Wonderful work Rob!
Rob Buttner@rob_buttner
Differentiating regular narrow and wide complex tachycardias can be a challenge. Can't see any P waves? Here are three handy tricks to make things easier 🧵👇
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@NadeevW @ralphoffenhouse Yes same concept in reverse, however no specific criteria to assess this
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@ralphoffenhouse @rob_buttner Morphology wise? Eg is late transition specific for VT as it suggests apical exit?
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@greedylobster They did it using the centralised monitor with just the rhythm strip
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@rob_buttner Can't do that on monitors in ED Rob... as far as I'm aware
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Differentiating regular narrow and wide complex tachycardias can be a challenge.
Can't see any P waves?
Here are three handy tricks to make things easier
🧵👇
English
@greedylobster I couldn’t figure it out either, but the lovely nurses managed to for me!
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