Had a pt like last night and the MD who just came off residency was very passive in the treatment to the point where the pts HR went from 50 to 40 to 30 and then into vfib. It was a complete disaster. We ended up treating the VFIB per acls protocol. But i think the pt would have had a better outcome had he not stalled for almost 10 minutes.
Now I ask you ER or experienced nurses, the pt's BP was 40/26 and HR 46, symptomatic and ekg confirmed a RV MI , how should this situation have been handled? Fluids? dopamine? atropine? levophed? These seem to the be the hardest MI's to treat