Cardiac stuff

I had a great weekend, went to a cardiac symposium put on by one of the local cardiology groups. It was held at the Arizona Golf Resort..very nice and great food. The speakers were informative and some of them were even funny. No, really, Cardiologists, funny, I swear. The latest stuff...lets see..not 3 nitros for chest pain, if you take one nitro wait 5 minutes if it doesn't help call 911. The newest dose of aspirin is 162mg, 325 after a stent for a month or so then down to 81 or 162 the whole time. Percutaneous valve replacements are being done at certain sites across the country right now but they are a thing of the future. To see all the info...www.tricitycardiology.com.
I had a 75 ya\ear old woman who went into rapid a fib even though she was on a maintinence dose of Cardizem. Her b/p was 100's over 60's...doc ordered 600mg of Rythmol then 150mg bid plus and increase to 240mg Cardizem. I was nervous, he said it would be fine...I warned my coworkers to keep an eye on her heart rate for me. I gave the Cardizem then about an hour later I gave the Rythmol. About an hour later she called and said she felt dizzy, I had the nursing assistant take her b/p but I went in the room as well...good thing, her b/p was 59/30... and she was on her way out. I called for the charge nurse, some saline and oxygen but I stayed with her, then I called the code. She was out not responding, couldn't get a b/p, eyes rolled back. I put the head of her bed down and was doing the "Annie Annie are you ok" thing when she opened her eyes, I was relieved ,somewhat ,but not out of the woods yet. Luckily the doc was still in the hospital and came when the code was called...we gave her fluids, some atropine, cuz her heart rate was 30, then she started to throw up...gave her some Zofran...and another bolus of fluids. The code team left and I was there with her and the doc. I stayed with her and explained a little bit of what happened, I called her family and at her request, asked them to come to the hospital. Her daughter ended up staying the night with her. She made it thru the crisis and went for a cardioversion the next day. To my surprise, when I asked the monitor room, they said she never did lose her heart rhythm, just her blood pressure.
Moral of the story...listen to your gut instinct. I didn't want to give the meds... I just had a feeling. The doc explained that the Cardizem would slow the rate and the Rhythmol would make her heart beat faster and that would hopefully convert her rhythm..it sounded good but I was still uncomfortable, which is why I enlisted my coworkers help to watch the monitor. Ah, the joys of cardiac nursing.
Non Noc Nocere