![]() ![]() The prehospital application of adult advanced cardiac life support guidelines utilizing IV diltiazem and electrical cardioversion for the treatment of RAF may be unnecessary. The data presented in this study suggest that given similar EMS system characteristics, prehospital RAF is an infrequently encountered, predominantly hemodynamically stable cardiac arrhythmia, readily treatable with symptomatic/supportive care, and cautious observation. For the management of atrial fibrillation with a ventricular rate > 100110/minute, see Afib with. Atrial flutter frequently progresses to Afib. Atrial flutter is typically more responsive to ablation therapy than Afib. No inappropriate use, point estimate (PE), or unmet need, PE of care was noted. Treatment is also similar to that of Afib, consisting of anticoagulation and strategies to control heart rate and rhythm. No cases occurred in which RAF resulted in severe hemodynamic instability. Paramedics documented improvement in 100% of patients. Symptomatic/supportive care consisting of observation (72.73%) and interventions (27.27%) with nitroglycerine, furosemide, aspirin, morphine, and/or IV fluid bolus therapy accounted for all prehospital treatment. Neither intravenous (IV) diltiazem or electrical cardioversion were used within the 12-month period of this study. Data collected included vital signs/ventricular rate, patient age, ambulance field times, patient chief complaint, prehospital interventions, efficacy of interventions, additional cardiac rhythms, iatrogenic complications, and patient past medical history. On review of 4,749 paramedic run reports from a low-volume urban emergency medical services (EMS) system, 33 persons (0.69%) presented with RAF. Doi: 10.1016/j.ajem.2021.08.082.The present study was completed to establish an epidemiological database defining prehospital rapid atrial fibrillation (RAF) and interventions given such patients in the hope of developing recommendations for further treatment protocols. ![]() Intravenous diltiazem versus metoprolol for atrial fibrillation with rapid ventricular rate: A meta-analysis. ischemia, metabolic or endocrine abnormalities, pulmonary embolism, heart failure or sepsis), and be sure to treat the underlying cause. So, what? This study suggests that while efficacy is similar at 120 minutes, IV diltiazem works more quickly than IV metoprolol for treatment of AF RVR in the ED.Īs always, remember to use caution with rate-controlling agents in patients with secondary causes of AF RVR (e.g.
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