I'm about two months into a new job at an urgent care. 50ish male came in, cardiac hx, decision had been made to transfer to ER, paramedic transport called and on their way. Pt was on a cardiac monitor, and I was preparing to insert his IV.
So I'm palpating his R ac, and he said: "ow, ow, you're shocking me!" I asked him where was I shocking him, and he pointed to his implanted defibrillator. Rhythm on the monitor was showing what I believe was brief runs of a fib, going back into sinus. I go to get help, all the other nurses were in pt rooms, so I ask the provider to come eval. Of course when two of the providers came out, pt was in sinus rhythm, no distress. They looked at me like I had two heads and said the pt would KNOW if his defibrillator was shocking him.
So, my question is, how does a pt know if his defibrillator is firing? Is it sometimes a small shock, sometimes a larger one? Could it have been a small one to take him out of a fib? Do you hear anything audibly when it happens?
Aug 27, '08
Thank you - no, he was definitely not in v tach or v fib. He was anxious about the situation, that's true, that was probably it. It could have been that he was trying to point to his left arm to show me he didn't like that I was palpating his vein. His vein was a zig-zag, I was worried I wasn't going to get an IV in there, but it was fine.
Last edit by GoldenFire5 on Aug 27, '08