Original Publication
Open Access

Wide Complex Tachycardia

Published: May 24, 2011 | 10.15766/mep_2374-8265.8499

Included in this publication:

  • WCT_Laerdal_SimMan.sce
  • WCT Case Media.docx
  • WCT Case Script.doc
  • WCT Critical Action.doc
  • WCT Instructor's Guide.doc
  • WCT Supplies.doc

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Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

Abstract

The purpose of this case is to prepare residents and students to care for patients in stable and unstable wide complex tachycardia. This case was created as part of our Emergency Medicine Resident Simulation Curriculum and is based on an actual patient seen in the author’s emergency department and highlights specific teaching points and potential pitfalls in treatment algorithms. In this simulation, a 49-year-old white male arrives at the emergency department feeling dizzy with history of non ischemic cardiomyopathy, multiple episodes of ventricular tachycardia status post-automatic cardioverter defibrillator/pacemaker presents with palpitations for approximately 1 hour. Patient is anxious and concerned. The goal is to have participants manage stable and unstable ventricular tachycardia and to prepare the team for potential complications of interventions (i.e., hypotension with antidysrhythmic infusion, progression to unstable ventricular tachycardia, require group to perform cardioversion). Each session typically involves four to five residents and takes approximately 15 minutes to administer. The session is then followed by a 30- to 45-minute debriefing. The simulation venue offers a unique opportunity to address team dynamics as well as provide a forum for didactic learning as it is often difficult to debrief a critical case while working in real-time patient-care settings.

Educational Objectives

By the end of this session, fourth year medical students, PGY-1, and PGY-2 will be able to:

  1. Gain proficiency in organizing team and assessing patient.
  2. Recognize wide complex tachycardia and differential diagnosis.
  3. Understand complications of ventricular tachycardia (VTach).
  4. Recognize management of stable and unstable VTach.

By the end of this session, PGY-3 and PGY-4 students will be able to:

  1. Exemplify mastery of team organization and assessment of agitated anxious patient.
  2. Recognize wide complex tachycardia and treat as VTach.
  3. Demonstrate mastery of treatment options and mechanism of action of antidysrhythmics for Vtach.

Author Information

  • Lauren Weinberger: Perelman School of Medicine at the University of Pennsylvania

Disclosures
None to report.

Funding/Support
None to report.



Citation

Weinberger L. Wide complex tachycardia. MedEdPORTAL. 2011;7:8499. https://doi.org/10.15766/mep_2374-8265.8499