Your patient is an 82-year-old woman whose daughter called E…

Your patient is an 82-year-old woman whose daughter called EMS because the patient became very short of breath as they walked from their parking spot to the front of their church. On your arrival, the patient states that she just needed a little rest and now feels much better. On questioning, she admits to several such episodes in the past month. She denies chest pain and she says, “I just got winded because I’m getting so old.” The patient has a heart rate of 104, a respiratory rate of 20, and blood pressure of 172/90 mmHg. Lung sounds are clear and equal bilaterally. Your history and physical examination should focus on which of the following possibilities?

A 24-year-old man has called 911 after experiencing heart pa…

A 24-year-old man has called 911 after experiencing heart palpitations and dizziness. You direct your partner to apply a 4-lead ECG and see a narrow complex tachycardia on the monitor at a rate of 196 bpm. The patient does not respond to vagal and medication attempts and your protocols direct you to perform syncrhonized cardioversion. The patient is wearing a halter monitor and states, “My doctor is making me wear this because I keep having these episodes.” The device’s leads location prevents you from applying the defibrillation/cardioversion pads in the proper location. How should you handle the presence of the halter monitor?