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Crossword Puzzles: |
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You are visiting an emergency department in Southern Australia this July. You are presented with an 87 year old female who fell while camping and fractured her left femoral neck. What does the EKG show and what is the diagnosis? Rate: 45 Rhythm: sinus bradycardia Axis: normal PR: normal QRS: broad Additional waves: J waves (best seen in V2 and V3) EKG diagnosis: sinus bradycardia Clinical diagnosis: 1) hypothermia 2) Fractured left femur Practice Points: - Hypothermia leads to sinus bradycardia and prolongation of the QT interval. Sometimes an extra wave is seen on the downstroke of the R-wave and is called a J-wave. -The J-waves become increasingly more pronounced as the temperature falls. The significance of the J-waves is unknown and they resolve as the patient becomes normothermic. -The patient is at risk of malignant ventricular arrhythmias |