ECG quiz

Question 1: What do you do?

• Discharge him

• Check his medications

• List him for pacemaker implantation

• List him for REVEAL (LINQ) device implantation

• 2 & 4

Question 2: What do you do?

• Reassure the patient

• Send troponin and wait for the results – then seek advice from Cardiology accordingly

• Send a non-urgent cardiology referral

• Call the Cardiology Registrar/Consultant for urgent advice

Question 3: What do you do?

• Repeat troponin – if no significant change he can be discharged

• Repeat troponin – if no significant change he can be seen in the cardiology admission avoidance clinic (next available slot is in 72 hrs)

• Admit under Cardiology irrespective of repeat troponin levels

• Refer to rapid access chest pain clinic (next available slot is in 2 weeks)

Question 4: What do you do?

• Stop the bisoprolol, reassure her, and discharge if physio fit

• Admit for observation under the medical team

• Stop the bisoprolol, discharge, and get GP to review in a week

• Refer to Cardiology for telemetry and possible pacemaker insertion

Question 5: What do you do?

• You make a note to discuss her case during the morning hand over

• You send her back to sleep and you reassure the nurses – no further action is required, she is well now

• You wake up the on call Cardiology Consultant and ask for urgent advice

• You make a note to discuss her with your Registrar when you see them during the break in a few hours

• You talk to your Registrar immediately as you are worried but you would never wake up a Cardiology Consultant

Question 6: What do you do?

• You refer her to cardiology for cardiac monitoring

• You admit under medicine for inpatient Neurology review

• You admit under medicine for inpatient Cardiology review

• You discharge her with referral to first fit clinic

• You talk to the medical registrar – you are really not sure what to do

Question 7: What do you do?

• You call the Neurology Registrar for advice – this is likely artefact from the movements during this possible seizure

• You call the Cardiology Registrar for urgent advice – this is a life threatening arrhythmia

• You call the Medical Registrar and ask them to help you – you are not sure what the diagnosis is but this rhythm strip was very wiggly!