13:00 more and more ERC and ESC seems to be heading towards adenosine for WCT. The only danger of giving vtac adenosine is , if it’s WPW with atrial fibrillation they’ll go into vfib (if you have the pads on you can shock them out of it, and it’s very rare) . As long as you rule out RRWCT of course I disagree that you won’t harm SVT with abberency with defib. Potentially you have a patient with atrial fibrillation / fludder who is not on anti coagulation , meaning you risk giving them a stroke So the risk of the very common thing Vs the risk of the uncommon thing you can shock someone out of . Am I missing something or are we overemphasising the risk of adenosine to WCT ?
What about a slightly wide QRS heart ryth(via Kardia mobileapp.) ? normal sinus rhythm(regular P waves) with wide QRS, good BP. good O2 saturation heart rate of 70 bpm...always 110/70 pressure. 59 year old male (former experienced Emergency medical tech.) Is this life threatening???
so a wide complex with a rate of 110bpm is not considered a WCT? I think it's correct to not be called VTach, but it would be considered tachycardia based on rate and it if over 120ms it would be a wide complex.
Great lecture and certainly it is very wise to just assume V-tach. However, esmolol is a selective B1 receptor blocker (in your lecture you said it is non-selective). Any idea why it would also be considered as efficacious as propranolol, which is non-selective, for electrical storm?
saving a soul is like saving the whole world, &there is no better deed than that, no better good deed than saving a person, or protecting him/her, or caring for someone whom is in need of care. Also, knowledge, and spreading useful knowledge, &wisdom, &perseverance, creative mind, skills, good attitude &good behavior, loving and respecting others, and having good communication skills, and doing good deeds.. are all beneficial. Be good dont be bad and refrain from sins and obey God and worship him alone in the way he wants to be worshiped and you will be saved from Hell fire and will enter paradise and be happy forever Whoever does an atom’s weight of good will see it, and whoever does an atom’s weight of evil will see it, or may not see it if God pardons him/her and has mercy on him/her that's if he/she try's to fix what he/she has spoiled, in the right time, When you give charity God protects you and blesses you with more good things in life or more money. A teaching from the prophet Mohammed may peace and blessings of God be upon his pure great soul and upon his great honorable progeny. When you be bad to others you will hurt your own self too, likewise when you don't do what you should in the right time. Having faith in God makes you stronger and makes you have hope even when things become very difficult for you and even when you are weak. Also: Drinking alcoholic beverages damages the liver and the mind. Adultery is not good, because it is not true love it is neglect to the lady and to the fetus, and brings sexual diseases, while marriage on the other hand, ok there is sex in marriage too and thats not a bad thing, its actually good, &is for the continuation of human race, & even for the here after its good for you because if you get children the good deeds of your children are counted as good deeds for both them and you, so they are a continuation of your own good deeds after you die and cant do good deeds any more, they are a continuation of you, & sex is to enjoy too, there is sex in marriage but marriage unlike adulatory it has love in it, it is a relationship in which the woman and the fetus are cared for, & even if they don't want to continue in a long lasting relationship they would at least have to be agreeing regarding the baby that the baby should be cared for, more especially the guy he has to know that he is responsible for the child infront of God even if he didnt want to have a child but he got one, he has to provide for him/her and to make sure the child becomes a good human being. Sodomy-same sex marriage-its bad and not part of normal human nature and life &it brings many sexual diseases. Eating pork can bring cholesterol &some parasitic worms. Not cheating, gaining trust by being a trust worthy honest person, & having good behavior, can help bring more money to you, and is good for you in the next life too. These are some of the teaching of the prophet Mohammed And this is from the quran from God to the prophet Mohammed and is part of the teachings of Islam, God says to the prophet: (50:45) (O Prophet), We are well aware of what they say; and you are not required to force things on them. So exhort with the Qur'an all those who fear My warning. *56 نحن أعلم بما يقولون وما أنت عليهم بجبار فذكر بالقرآن من يخاف﴿ We are most knowing of what they say, and you are not over them a tyrant. But remind by the Qur'an whoever fears My threat. نَحْنُ أَعْلَمُ بِمَا يَقُولُونَ ۖ وَمَا أَنْتَ عَلَيْهِمْ بِجَبَّارٍ ۖ فَذَكِّرْ بِالْقُرْآنِ مَنْ يَخَافُ وَعِيدِ 45Sé muy bien lo que dicen de ti [¡oh, Mujámmad!]. Pero tú no puedes forzarlos a creer, solo exhórtalos con el Corán, que quien tema Mi amenaza recapacitará. سم الله الرحمن الرحيم قُلْ لِلَّذِينَ آمَنُوا يَغْفِرُوا لِلَّذِينَ لَا يَرْجُونَ أَيَّامَ اللَّهِ لِيَجْزِيَ قَوْمًا بِمَا كَانُوا يَكْسِبُونَ 14 . Tell those who believe, to forgive those who do not look forward to the Days of Allah: It is for Him to recompense (for good or ill) each People according to what they have earned. مَنْ عَمِلَ صَالِحًا فَلِنَفْسِهِ ۖ وَمَنْ أَسَاءَ فَعَلَيْهَا ۖ ثُمَّ إِلَىٰ رَبِّكُمْ تُرْجَعُونَ 15 If any one does a righteous deed, it ensures to the benefit of his own soul; if he does evil, it works against (his own soul). In the end will ye (all) be brought back to your Lord. The final messenger of God Muhammad is the most perfect human ever, all the good character and all the good behavior and all good qualities were found in him, & he was the most intelligent man, his mind was the brightest mind, & he was the most merciful of all people, his heart was the most loving largest whitest & kindest heart, and was the most tolerating and most patient with others, and most pardoning to others, and most forgiving and most kind, but was also brave, Prophet Mohammed was the bravest person ever, and was the firmest person against all types of crimes and against deviating from the good teachings of God, &was the most just in his own ways the way of God & most generous & kind, and had God always in his mind and was the most grateful human to God even when he had nothing, and was the most honest most trustworthy person ever, and most persevering human ever, and asked people to do every good deed possible and to refrain from evil deeds and sin, Prophet Mohammed may peace and blessing be upon him and upon his successor imam Ali and his God fearing God loving progeny taught every good, & taught people to respect & love & care for each other, & for the female, & elder, & children, & to protect the innocent person regardless of what he/she believed in, (If one of the polytheists seeks protection from you, then grant him protection) Holly Quran, & taught to either forgive the one who wronged you, or be just & fair when retaliating, or to shock the person and enslave his/her heart by being generous &kind. & taught to not waste money and resources and not to harm the environment, and to try to have a good hygiene and to try to look good and to try to smell good and to take good care of your own self, and to enjoy what God didn't forbid, so to be grateful to God, and protect your self and others from harm, and to defend the religion the final religion which God will accept and will accept no other than it anymore. & regarding the topic: Who to follow after the prophet!?, who are the extension of him and his light, well, try to find out by your self, however, in summery, to give you a hint: Even if you may think that all the companions of the Messenger were always good and all of them are like mountains, despite everything that happened between them!!! the Prophet said: “My family-daughter Fatima the lady of light the lady of heaven and Imam Ali and their great offspring's and special perfect chosen descendants-are like the ark-/ship-of Noah, whomever embarked on it survived, and whomever did not drowned and perished-/died-. &We know that the son of Noah did not embark on the ark/ship of salvation, rather he climbed a mountain and drowned due to the very high tides and because he didn't follow God command. Don't be like him spread the light teach what's good &right its best for you and for all and better than letting the wrong things from wrong teachings or bad desires and ill mind happen, prevention is better than cure , Spread this message in both the muslim and non muslim world to counter terrorism and to also spread good understanding between nations too: The prophet Mohammed taught to not attack the civilians, & not only that, even the combatant whom is running away from the battel field and is not willing to fight any battel against you anymore, and also the injured combatant whom cant fight, he too shouldn't be harmed, and even the combatant who killled many solders while in the battel but then surrenders & truly repents and becomes a muslim&says ashhadu-I testify/I bear witness-anna/that la ilah illa Allah there is no God other than the one and only true God who created all, wa-and- anna Mohammed resolu Allah, the prophet Mohammed is his messenger, He should not be killed. & it is clear in the quran in more than one verse, to not fight except those who fight you. ,, ,
@@rubenlarotin3141 WoW!!! You are too beautiful.. whomever see you should believe that God is true & real.. and whenever I see you I feel like Iam in a dream... And when we wake up we will all realize that all this life was nothing but a dream and that only God is whats true and real.. ❤🌷Even if let say I never seen your lovely beautiful radiant cute baby face nor touched you in any place nor smelled and kissed your wonderful neck and breast.. nor heard your lovely soft warm voice you still know that you exist, & Its true that we dont see God but we all know that God exists There was a teacher who did not believe in the existence of God, he said to his students, do you see God? the students answered no we don't see God, so the teacher said if you don't see God it means there is no God. then a smart student stood up and said to the other students hey guys can you see the teachers brain? then the student answered no we don't see the teachers brain, the student then said the teacher is crazy he has no brain :0) the universe science says was not always there it had a beginning point the big bang meaning it was begun initiated in other words created, thus there should be a creator, there must be a God, we don"t see God and we don"t know the essence of God thats a different story, But we see how things in the universe obey rules and we see some wisdom in things indicating he is knowledgeable and wise, and we see different things many verity of things and creatures and that indicates the capability of God, and we also see that all things are made of almost the same thing for example everything is made-up of particles and energy and space or vacuum, meaning they share a similarity some how indicating unity Which proves that the creator of all things is one One God for all of us And God is the creator of space and time and time and space came together they were created together Meaning that God is not found within the space time dimension And is greater than to be contained within space and time frame and borders, also whatever was proven to exist-the universe proves the existence of God- but was not proven by scientific facts and evidence-¬ by logic alone-to not have had a beginning point it means that there is a possibility that That thing may have existed all the time and was not begun or created and thus has no creator,, the universe proves the existence of God but God not proven by scientific evidence & not logic alone that he had a beginning point, so God may have existed all the time, yes God existed all the time if God proven to exist but had no beginning point also that means he has no creator. God initiated everything and he repeats things too, and thats clear we see many cycles of things, water cycle, animal and plants food chain cycle, God created this life and it is only a temporary sample or an example of a coming everlasting one which could be either in heaven paradise or in hell. If we try to be good humans in life and try to obey God and his messengers and those whom rightly represent them, then we will go to heaven/paradise, if not we will go to hell fire and burn in it forever.,,
Great talk thanks
Very easy to remember in an Acute setting.
Thank you Madam.... you are a super cool teacher...
Informative summary for stable WCTs!
Amazing, thank you Dr. Fix !
13:00 more and more ERC and ESC seems to be heading towards adenosine for WCT.
The only danger of giving vtac adenosine is , if it’s WPW with atrial fibrillation they’ll go into vfib (if you have the pads on you can shock them out of it, and it’s very rare) . As long as you rule out RRWCT of course
I disagree that you won’t harm SVT with abberency with defib. Potentially you have a patient with atrial fibrillation / fludder who is not on anti coagulation , meaning you risk giving them a stroke
So the risk of the very common thing Vs the risk of the uncommon thing you can shock someone out of .
Am I missing something or are we overemphasising the risk of adenosine to WCT ?
What about a slightly wide QRS heart ryth(via Kardia mobileapp.) ? normal sinus rhythm(regular P waves) with wide QRS, good BP. good O2 saturation heart rate of 70 bpm...always 110/70 pressure. 59 year old male (former experienced Emergency medical tech.) Is this life threatening???
Very informative and useful
Awesome great and interesting topic
so a wide complex with a rate of 110bpm is not considered a WCT? I think it's correct to not be called VTach, but it would be considered tachycardia based on rate and it if over 120ms it would be a wide complex.
great video
Good presentation
Great lecture and certainly it is very wise to just assume V-tach. However, esmolol is a selective B1 receptor blocker (in your lecture you said it is non-selective). Any idea why it would also be considered as efficacious as propranolol, which is non-selective, for electrical storm?
Thank you!
Perfect
Beautiful and intelligent :)
Very nice
So EP was right
And procainamide is much much cheaper
It's VTach
saving a soul is like saving the whole world, &there is no better deed than that, no better good deed than saving a person, or protecting him/her, or caring for someone whom is in need of care.
Also, knowledge, and spreading useful knowledge, &wisdom, &perseverance, creative mind, skills, good attitude &good behavior, loving and respecting others, and having good communication skills, and doing good deeds.. are all beneficial.
Be good dont be bad and refrain from sins and obey God and worship him alone in the way he wants to be worshiped and you will be saved from Hell fire and will enter paradise and be happy forever
Whoever does an atom’s weight of good will see it, and whoever does an atom’s weight of evil will see it,
or may not see it if God pardons him/her and has mercy on him/her that's if he/she try's to fix what he/she has spoiled, in the right time,
When you give charity God protects you and blesses you with more good things in life or more money.
A teaching from the prophet Mohammed may peace and blessings of God be upon his pure great soul and upon his great honorable progeny.
When you be bad to others you will hurt your own self too,
likewise when you don't do what you should
in the right time.
Having faith in God makes you stronger
and makes you have hope even when things become very difficult for you
and even when you are weak.
Also:
Drinking alcoholic beverages damages the liver and the mind.
Adultery is not good, because it is not true love it is neglect to the lady and to the fetus, and brings sexual diseases,
while marriage on the other hand, ok there is sex in marriage too and thats not a bad thing, its actually good, &is for the continuation of human race, & even for the here after its good for you because if you get children the good deeds of your children are counted as good deeds for both them and you, so they are a continuation of your own good deeds after you die and cant do good deeds any more, they are a continuation of you, & sex is to enjoy too,
there is sex in marriage but marriage unlike adulatory it has love in it, it is a relationship in which the woman and the fetus are cared for, & even if they don't want to continue in a long lasting relationship they would at least have to be agreeing regarding the baby that the baby should be cared for, more especially the guy he has to know that he is responsible for the child infront of God even if he didnt want to have a child but he got one, he has to provide for him/her and to make sure the child becomes a good human being.
Sodomy-same sex marriage-its bad and not part of normal human nature and life &it brings many sexual diseases.
Eating pork can bring cholesterol &some parasitic worms.
Not cheating, gaining trust by being a trust worthy honest person,
& having good behavior, can help bring more money to you, and is good for you in the next life too.
These are some of the teaching of the prophet Mohammed
And this is from the quran from God to the prophet Mohammed and is part of the teachings of Islam, God says to the prophet:
(50:45) (O Prophet), We are well aware of what they say; and you are not required to force things on them. So exhort with the Qur'an all those who fear My warning. *56
نحن أعلم بما يقولون وما أنت عليهم بجبار فذكر بالقرآن من يخاف﴿
We are most knowing of what they say, and you are not over them a tyrant. But remind by the Qur'an whoever fears My threat.
نَحْنُ أَعْلَمُ بِمَا يَقُولُونَ ۖ وَمَا أَنْتَ عَلَيْهِمْ بِجَبَّارٍ ۖ فَذَكِّرْ بِالْقُرْآنِ مَنْ يَخَافُ وَعِيدِ
45Sé muy bien lo que dicen de ti [¡oh, Mujámmad!]. Pero tú no puedes forzarlos a creer, solo exhórtalos con el Corán, que quien tema Mi amenaza recapacitará.
سم الله الرحمن الرحيم
قُلْ لِلَّذِينَ آمَنُوا يَغْفِرُوا لِلَّذِينَ لَا يَرْجُونَ أَيَّامَ اللَّهِ لِيَجْزِيَ قَوْمًا بِمَا كَانُوا يَكْسِبُونَ
14 .
Tell those who believe, to forgive those who do not look forward to the Days of Allah: It is for Him to recompense (for good or ill) each People according to what they have earned.
مَنْ عَمِلَ صَالِحًا فَلِنَفْسِهِ ۖ وَمَنْ أَسَاءَ فَعَلَيْهَا ۖ ثُمَّ إِلَىٰ رَبِّكُمْ تُرْجَعُونَ 15
If any one does a righteous deed, it ensures to the benefit of his own soul; if he does evil, it works against (his own soul). In the end will ye (all) be brought back to your Lord.
The final messenger of God Muhammad is the most perfect human ever, all the good character and all the good behavior and all good qualities were found in him, & he was the most intelligent man, his mind was the brightest mind, & he was the most merciful of all people, his heart was the most loving largest whitest & kindest heart, and was the most tolerating and most patient with others, and most pardoning to others, and most forgiving and most kind, but was also brave, Prophet Mohammed was the bravest person ever, and was the firmest person against all types of crimes
and against deviating from the good teachings of God,
&was the most just in his own ways the way of God & most generous & kind, and had God always in his mind and was the most grateful human to God even when he had nothing, and was the most honest most trustworthy person ever, and most persevering human ever, and asked people to do every good deed possible and to refrain from evil deeds and sin, Prophet Mohammed may peace and blessing be upon him and upon his successor imam Ali and his God fearing God loving progeny
taught every good, & taught people to respect & love & care for each other, & for the female, & elder, & children, & to protect the innocent person regardless of what he/she believed in,
(If one of the polytheists seeks protection from you, then grant him protection) Holly Quran,
& taught to either forgive the one who wronged you, or be just & fair when retaliating, or to shock the person and enslave his/her heart by being generous &kind. & taught to not waste money and resources and not to harm the environment, and to try to have a good hygiene and to try to look good and to try to smell good and to take good care of your own self, and to enjoy what God didn't forbid, so to be grateful to God, and protect your self and others from harm, and to defend the religion the final religion which God will accept and will accept no other than it anymore.
& regarding the topic: Who to follow after the prophet!?,
who are the extension of him and his light, well, try to find out by your self, however,
in summery, to give you a hint:
Even if you may think that all the companions of the Messenger were
always good and all of them are like mountains, despite everything that happened between them!!!
the Prophet said: “My family-daughter Fatima the lady of light the lady of heaven and Imam Ali and their great offspring's and special perfect chosen descendants-are like the ark-/ship-of Noah, whomever embarked on it survived, and whomever did not drowned and perished-/died-.
&We know that the son of Noah did not embark on the ark/ship of salvation, rather he climbed a mountain and drowned due to the very high tides and because he didn't follow God command. Don't be like him
spread the light teach what's good &right its best for you and for all and better than letting the wrong things from wrong teachings or bad desires and ill mind happen, prevention is better than cure ,
Spread this message in both the muslim and non muslim world to counter terrorism and to also spread good understanding between nations too:
The prophet Mohammed taught to not attack the civilians,
& not only that, even the combatant whom is running away from the battel field and is not willing to fight any battel against you anymore, and also the injured combatant whom cant fight,
he too shouldn't be harmed, and even the combatant who killled many solders while in the battel but then surrenders & truly repents and becomes a muslim&says ashhadu-I testify/I bear witness-anna/that la ilah illa Allah there is no God other than the one and only true God who created all, wa-and- anna Mohammed resolu Allah, the prophet Mohammed is his messenger, He should not be killed.
& it is clear in the quran in more than one verse, to not fight except those who fight you. ,, ,
please don't spam here
did i miss something 😮😂
@@rubenlarotin3141
WoW!!!
You are too beautiful..
whomever see you should believe that God is true & real..
and whenever I see you I feel like Iam in a dream...
And when we wake up we will all realize that all this life was nothing but a dream and that only God is whats true and real..
❤🌷Even if let say I never seen your lovely beautiful radiant
cute baby face
nor touched you
in any place
nor smelled and kissed your wonderful neck and breast..
nor heard your lovely soft warm voice
you still know that you exist,
& Its true that we dont see God but we all know that God exists
There was a teacher who did not believe in the existence of God, he said to his students, do you see God?
the students answered no we don't see God, so the teacher said if you don't see God it means there is no God.
then a smart student stood up and said to the other students hey guys can you see the teachers brain?
then the student answered no we don't see the teachers brain, the student then said the teacher is crazy he has no brain
:0)
the universe
science says
was not always there it had a beginning point
the big bang
meaning it was begun initiated in other words created,
thus there should be a creator,
there must be a God,
we don"t see God and we don"t know the essence of God thats a different story,
But we see how things in the universe obey rules and we see some wisdom in things indicating he is knowledgeable and wise, and we see different things many verity of things and creatures
and that indicates the capability of God,
and we also see that all things are made of almost the same thing
for example everything is made-up of particles
and energy and space or vacuum,
meaning they share a similarity some how indicating unity
Which proves that the creator of all things is one
One God for all of us
And God is the creator of space and time and time and space came together they were created together
Meaning that God is not found within the
space time dimension
And is greater than to be contained within space and time frame and borders, also whatever was proven to exist-the universe proves the existence of God-
but was not proven by scientific facts and evidence-¬ by
logic alone-to not have had a beginning point it means that
there is a possibility that
That thing may have existed all the time and was not begun or created and thus has no creator,, the universe proves the existence of God but God not proven by
scientific evidence
& not logic alone
that he had a beginning point, so God may have existed all the time, yes God existed all the time
if God proven to exist but had no beginning point also that means
he has no creator.
God initiated everything and he repeats things too, and thats clear we see many cycles of things, water cycle,
animal and plants
food chain cycle,
God created this life and it is only a temporary sample or an example of a coming everlasting one which
could be either in heaven paradise or in hell.
If we try to be
good humans in life and try to obey God and his messengers and those whom rightly represent them, then we will go to heaven/paradise, if not we will go to hell fire and burn in it forever.,,