Michael Bessette, MD Situation Josephine Slowvicki, a 55 yo housekeeper, is brought into the ED by her coworker because she is pale and feels like she is going to faint. The patient reports not feeling well for several hours. She has a history of diabetes, and she reports taking her insulin 2 hours ago, but has not yet eaten.
Patient denies chest pain but does feel short of breath.
She is nauseous, but no vomiting. Discuss your initial management. Review the difference between first second, and third degree heart block. The patient is placed on the transcutaneous pacer and set at 60. The patient felt better, but was uncomfortable secondary to the pacer.