Michael Bessette, MD Situation Juanita Rapidita, a 45 y.o. Hispanic female is walked into the ED by the triage nurse with a complaint of palpitations. Physical Exam reveals a well developed and well nourished HF, alert on stretcher. Lungs are clear, heart is tachy and regular.
Extremities show no edema.
What pharmacological intervention would be appropriate After 12 mg of Adenosine the patient felt better and her heart rate slowed to 60. Repeat EKG was obtained. On review of systems it was discovered that the patient has been having melenotic stools over the last 2 days. Rectal was performed and it was heme positive black stool. She was transferred to the ICU, immediately endoscoped, but during the endoscopy she coded, but survived and received 6 units of blood.