Take the following case:
A nice guy gets bypassed and is recovering in the Intensive Care Unit. Everything has gone as planned and his post-operative course has been completely uneventful. He is extubated post-op day one and is sore, but breathing fairly well, has a good blood pressure and urine output, and (most importantly) the ICU nurses are happy.You recognize the simple problem that took place and fix the problem.
Until the following morning. Suddenly, he starts "throwing PVC's" and then, BLAMMO, this happens:
Click image to enlarge
The ICU nurse recognizes the rhythm and shocks the patient back to normal rhythm, the ICU intern starts Amiodarone and calls the cardiologist. The cardiologist recommends to pace the patient faster and call the EP to see what can be done to prevent this from happening.
What did you see and do?