List Archives

Fri, 22 Feb 2002 15:59:04 -0500

Nick, 

Absolutely possible, but uncommon and unlikely.  Anoxia most frequently
leads to bradycardia, not VF.  And although I agree that you should treat
the patient, not the monitor, I can recall at least one case of a teenage
girl with Long QT who was treated for several minutes as a seizure before
anyone checked her pulse OR rhythm (Torsades).  Leaves a bad taste.

I think that most folks who have witnessed a conscious patient suffering
sudden-onset VF would agree that the physical manifestations could fairly be
mistaken for seizure activity.  This more clearly speaks to the original
post: sudden death is rarely subtle.

Best Regards,

Pret

-----Original Message-----
From: Nick Nudell [mailto:nick@glacierems.com]
Sent: Thursday, February 21, 2002 7:59 PM
To: trauma-list@trauma.org
Subject: Re: v-fib seizure

I think there is more then one plausible explanation.... try yours in
reverse!

Like this:
Seizure activity > Anoxia > Cardiac ischemia > V-fib

In addition, reading V-fib on a monitor during seizure activity can be
dangerous. Treating your patient (meaning check for pulses) is probably more
critical then reading the monitor.

Turn this into a further discussion by asking, at times finding a pulse may
be difficult during seizure activity, so would you first give a med (benzo
or other relaxant) and intubate or would you jump to ACLS and Shock Shock
Shock?

Take care.
Nick

P.S. Your right, this is not really a trauma discussion, other then what if
the seizure was caused by head injury leading to this crashing spiral?

____
Nick Nudell, NREMT-P
Glacier County EMS
www.glacierems.com
Northern Rockies Medical Center
Cut Bank, MT
nick@glacierems.com

----- Original Message -----
From: <Nappio@aol.com>
To: <trauma-list@trauma.org>
Sent: Thursday, February 21, 2002 4:38 PM
Subject: Re: v-fib seizure

> ATTENTION:
>
> V-fib  >    Anoxia   >   Ischemic brain hit    >    seizure activity
>
> Mr. Ramstrom,  Mr. Clopp asked the rhetorical "stupid question" if you
will,
> and stated the truth about his knowledge deficit,,but at least he stepped
> forth  and asked the question so he wouldnt be just a cook book ambulance
> driver.If you want to eliminate the negative attitudes you speak of you
have
> to accept the fact that there are cook book ambulance drivers who need to
be
> educated.
> DN
>
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/traumalist.html
>

--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/traumalist.html

List Archives

For your convenience, find the Trauma List Archive Below

v-fib seizure