Arrhythmias *

Objectives (EM)

1. Given a patient presenting with non-specific symptoms that may be from hypoperfusion (e.g., dizziness, vertigo, light-headedness, syncope, presyncope), rule out arrhythmia as a possible cause.
2. When interpreting a patient’s ECG, identify subtle signs that may indicate a risk of serious arrhythmia (e.g., prolonged QT in toxicology, peaked T waves in hyperkalemia, delta waves in palpitations).
3. When interpreting an ECG or rhythm strip of a patient with an arrhythmia, use a systematic approach to the interpretation of the arrhythmia (e.g., differential diagnosis of narrow or wide complex tachycardia, diagnose AV blocks).
4. In managing a patient with an arrhythmia, distinguish between stable and unstable presentations (e.g., signs of inadequate perfusion, risk of imminent collapse) and select the most appropriate treatments (electrical and/or pharmacological) according to the stability of the patient.
5. Given a patient with a specific arrhythmia, establish a differential diagnosis of the likely precipitating causes.
6. In a patient presenting with a specific arrhythmia (e.g., WPW, toxicology, hypothermia, prolonged QT), adjust management to the special circumstance.
7. In a patient with a reperfusion arrhythmia, manage supportively with clearly indicated pharmacotherapy.
8. Given a patient who has return of spontaneous circulation following cardiac arrest, initiate therapeutic hypothermia as indicated.