ABCDE Assessment Essay Example
ABCDE ASSESSMENT 6
The rhythm in the ECG chart is irregularly irregular and rapid. The QRS complex is narrow. The atrial activity is characterized by absence of P waves. This indicates that this condition is the Atrial Filbrilllation (Wagner & Marriott, 2008). This is because there rapid ventricular response as it can be deduced from the chart. However, the patient is stable. This can be seen from many factors. One of the factors is that the patient is conscious and can respond. The patient can also breathe well and talk. This makes the condition of the patient to be stable. Although the condition is stable, the high level of troponin I show damage to the cardiac system.
AFib is a condition that is characterized by the occurrence of a rhythm that is irregularly irregular while the P waves are absent. The ventricular response of the condition can be said to rapid, controlled or slow depending on the rate. If the rate is 120/minute, the rate is said to be rapid. If the rate is between 70 and 110 per minute, is said to be controlled and when the rate is less than 60/minute, it is said to be slow (Wagner & Marriott, 2008). In the case of Mr. Wilson, the rate is rapid. The condition is also characterized by the presence of fib waves which manifest themselves as undulations in the baseline.
The clinical priorities for Mr. Wilson include finding the cause of the condition, fixing the cause of the condition, slowing the rate of the ventricular response, converting the rhythm and prevention of thromboembolism (Handler, Handler & Coghlan, 2008). The reason for suggesting the priorities listed above in the sequence in which they are given is because if the cause of AFib can be found and fixed at the onset of the condition, then it will be possible to convert the rhythm, slow the rate and minimize the chances of stroke. Several actions need to be taken simultaneously when treating AFib. Among the actions that need to be undertaken is to consider the likely precipitating cause or causes and work to correct the situation. The common causes of atrial fibrillation include cardiomyopathy, heart failure, acute MI, valvular disease, hypertension, hypothyroidism, pulmonary embolus, drugs, hypoxemia, lone and sick sinus syndrome. The most likely cause of AFib in the case of Mr. Wilson is acute MI (Aehlert & Vroman, 2011). this is indicated by the high production of Troponin I. this is also supported by the kind of treatment the doctor recommended. The kind recommended the patient to be treated Clopedigrol 600mg which is usually the treatment for acute MI among other heart diseases.
The main treatment concern of new-set AFib is slowing the rate. This is usually carried out in an ED setting where IV Diltiazem is administered through a process known as bolus and infusion. The patient should be given 15-20 mg of IV Diltiazem through IV bolus. This should be followed with a second bolus of about 25 mg IV after 15 minutes if the patient shows no response. After the second bolus, IV infusion may be started. This is to be done at 10 mg/her. Verapamil and Digoxin may be used in place of Diltiazem (Handler, Handler, & Coghlan, 2008). However, this medical intervention can only be carried out after a through analysis of ECG. This helps in ascertaining the true cause of the condition. The medical workup of AFib involves considering the likely cause or causes and treating the cause.
The medical recommendations given by the doctor serve to help the patient in a number of ways and also ascertain the presence of certain conditions. Oxygen therapy used to help the patient with breathing. The acute chest pains felt by Mr. Wilson could imply that he might have been suffering from COPD. This condition prevents patients from getting enough oxygen through normal breathing. The FBC (full blood count) was used to check the general health of the patient as well as checking for conditions such as anemia (Chung, 2003). FBC is useful because it providers pointers about the health problems in a patient. The EUC test is carried out to ascertain the chemical composition of blood. Changes in the chemical composition of blood will indicate that there is a problem in the body, especially the kidney. The EUC test in Mr. Wilson’s case is used to ascertain the level of troponin I in blood. This helps in ascertaining the level of damage on the cardiac system. The LFT test was carried out to determine any problem with the liver. The test measures the level of certain chemicals, produced by the liver, in the blood. The chemicals include alanine transaminase, aspartate aminotransferase, alkaline phosphatase, albumin among others (Aehlert & Vroman, 2011). However, aspartate aminotransferase can also be discharged in the blood if the heart is damaged. This was the most probably function of the test in the case of Mr. Wilson. The BSL test was carried to test the blood sugar level. This test was important owing to the weight of Mr. Wilson. Considering a height of 160cm, a weight of 95kg makes Mr. Wilson to be overweight. All these tests are crucial in ascertaining the true cause of the problem.
The medications ordered by the medical officer were meant to serve various purposes. Clopedigrol 600mg was meant to treat any cardiac injury suffered by Mr. Wilson. All indications point that Mr. Wilson had suffered from a cardiac complication. This is supported by the high levels of Troponin I and CK-MG in his blood. The high level of Troponin in blood means that there damage to the cardiac. Clopedigrol 600mg was therefore used to treat the damage on the cardiac system. In most cases, the damage on the cardiac system is caused by acute MI. in principle, therefore, Clopedigrol 600mg is used to treat acute MI (Aehlert & Vroman, 2011). another medication that was ordered by the medical officer was Anginine. Anginine is medicine that is used to treat and prevent angina attacks. Angina is an uncomfortable feeling or pain in the chest. It usually caused by lack of enough oxygen reaching the heart, making he heart muscles to spasm. The medical officer recommended the use of anginine because signs also indicated the possibility of Mr. Wilson suffering from angina. This is because Mr. Wilson had chest pains that were not made worse by breathing. Morphine was only meant to reduce pain.
In all indications, Mr. Wilson is suffering from a heart disease. However, the condition was not very severe because tests indicated that respiratory rate and heart rate were normal. The high score GCS also indicated that he had suffered in brain injuries. However, his blood pressure and level of troponin and CK-MB were so high indicating that there was a problem with his cardiac system.
Aehlert, B., & Vroman, R. (2011). Paramedic practice today: Above and beyond. St. Louis, Mo: Mosby Jems Elsevier
Chung, E. K. (2003). 100 qustions and answers about heart attack and related cardiac problems. Boston: Jones and Bartlett Publishers
Handler, C. E., Handler, C., & Coghlan, G. (2008). Management of cardiac problems in primary care. Oxford: Radcliffe.
Wagner, G. S., & Marriott, H. J. L. (2008). Marriott’s practical electrocardiography. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
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