Quote from wtbcrna
Assuming that this pt is having 20 PVCs in one minute! I don't think that atropine would be the drug you would want to give...lidocaine, amidorone, or some other antiarrythmic would be a better choice. The most important thing to identify is what you already mentioned 70BPM with 20 PVCs (also need to identify if they are unifocal or multifocal PVCs) and if the pt is symptomatic.
Interesting question I don't think I have ever heard someone ask that question before.
I wouldn't necessarily assume they are having 20 PVCs in a minute unless the strip appears that they are bigeminal, trigeminal, etc. Some people just have PVCs at random, and it could just be my luck that I caught 2 on the same strip.
Assuming they were having 20 PVCs a minute, yeah, my priority would be to determine the underlying cause of the PVCs (electrolyte imbalances, etc.) and treat that, maybe use some lidocaine, etc. I was more referring to just the odd random PVC, not a regular pattern of them.
The reason I am so curious is partly because I am responsible for interpreting strips on exams, and because all of the clinical units I am on this quarter (advanced care and CICU), every patient is on a heart monitor and one of my morning duties is to pull a strip and analyze it for the chart. I guess part of this is a moot point because if I am looking at a strip that comes off a heart monitor, the monitor will put the HR there for me. Which begs the question: do heart monitors count PVCs in the rate? Hmm... I'll have to start looking.