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ADVANCED CONCEPTS Scenario F: Mr. Calico Mr. Calico, age 76, was taking a walk when he developed chest heaviness. He went inside and told his wife he was going to lie down on the sofa for a while. She grew concerned an hour later when she called his name and he didn’t answer. Mrs. Calico called 911 and the paramedics arrived to find Mr. Calico in the rhythm seen in Figure 18-19. 1. What is this rhythm? 2. What symptoms would you expect to see in Mr. Calico? 3. Mr. Calico was unconscious and had no pulse and no breathing. What should the paramedics do to resuscitate Mr. Calico? After appropriate initial treatment, Mr. Calico’s pulse returned and he began to awaken. The paramedics ran another rhythm strip. See Figure 18-20. 4. What is this rhythm? Paramedics rushed Mr. Calico to the nearest hospital, where a 12-lead EKG was done. His 12-lead EKG is seen in Figure 18-21. 5. What conclusion do you draw from this EKG? 6. Thrombolytic medication was started and the EKG was repeated. See Figure 18–22. What has changed since the last EKG? 7. Mr. Calico went into ventricular fibrillation a few minutes later. The nurse prepared to cardiovert the rhythm, but when he depressed the buttons to deliver the shock, nothing happened. Why and what corrective action is needed for this problem? After correctly defibrillating Mr. Calico, the ER staff sent him to the CCU, where he spent a week recovering. He went home and did well with no further problems. FIGURE 18-19 Mr. Calico’s initial rhythm. va FIGURE 10_n AVR 1 Va { M M . avi . E AVE IV VA 1 루 FIGURE 18-21 Mr. Calico’s initial 12-lead EKG. AVR VA VE 3 커 도 IV V. av! th 국 루 로 VA HE AVE h ㄴ fr 과 h A FIGURE 18-22 Mr. Calico’s EKG after thrombolytic medication.
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