Has anyone ever heard of Wolff-Parkinson-White Syndrome?
So a student came in with dizziness and feeling like he was going to faint. So of course, I did a full assessment. Blood pressure and heart rate was pretty high.
Had him rest a bit, rechecked his vitals again and they had gone down a bit.
I auscultated and his heart rate was fluctuating (palpitations) from fast to slow and vice versa.
Mom took him immediately to the doctor and he was diagnosed with WPW. WPW is rare and children usually grow out of it without any treatment, unless there are other underlying heart issues. He was referred to a Cardiologist for further assessment. Either way, I was so happy to have caught it and send him out! This was a small yet amazing victory, especially in this field where I am constantly questioned for decisions I make and even though only AN, my mom and I know about this, I am super proud right now!
Vagal maneuvers. These simple physical movements - which include coughing, bearing down as if you are having a bowel movement and putting an ice pack on your face - affect a nerve that helps regulate your heartbeat (vagus nerve). Your doctor may recommend performing vagal maneuvers to help slow a rapid heartbeat when it occurs.
Medications. If vagal maneuvers don't stop the fast heartbeat, you may need an injection of an anti-arrhythmic medication. Your doctor also may recommend a medication that can slow the heart rate.
Cardioversion. Your doctor may use paddles or patches on your chest to electrically shock your heart and help restore a normal rhythm. Cardioversion is typically used when maneuvers and medications aren't effective.
Radiofrequency catheter ablation. Thin, flexible tubes (catheters) are threaded through blood vessels to your heart. Electrodes at the catheter tips are heated to destroy (ablate) the extra electrical pathway causing your condition. Radiofrequency ablation permanently corrects the heart-rhythm problems in most people with WPW syndrome.
Well, here's what I'll add about that...BAM! Another kid snatched from the jaws of death! School nurses, that's what we do, one kid at a time! coffee...you saved this family a lot of tragedy. Fantastic assessment and intervention, NURSE!!!
Gonna print this and frame it.
lol
you know when OldDude says this you automatically become cool:yes:
Great catch!! So glad you were there to do a thorough assessment on this student! We will never know how much potential heartbreak you saved this student and family!
Yes, my brother was actually diagnosed with this but it was not caught until he was 21. He passed out while at work, he ended up having a single bypass and has been fine ever since.
Looks like it may have been this that he had after reading a previous post....: Radiofrequency catheter ablation. Thin, flexible tubes (catheters) are threaded through blood vessels to your heart. Electrodes at the catheter tips are heated to destroy (ablate) the extra electrical pathway causing your condition. Radiofrequency ablation permanently corrects the heart-rhythm problems in most people with WPW syndrome.
I was young...I just know they went in thru his groin...he's 45 now so it's been a minute since it took place.
I had a kid come in and say his heart was beeping. rate was over 200. he was pale and diaphoretic, I did some vagal maneuvers and it went down to 160ish. diagnoses with WPW came next!
gonzo1, ASN, RN
1,739 Posts
You are awesome.