“How Do You Manage Unstable Atrial Fibrillation in Emergency Medicine and Critical Care?” From CriticaCareNow

Today, I link to, embed, and excerpt from CriticalCareNow‘s How Do You Manage Unstable Atrial Fibrillation in Emergency Medicine and Critical Care?

All that follows is from the above resource.

May 21, 2023 ResusX:Podcast

In this video, Sara Crager discusses the management of Unstable A-Fib (Atrial Fibrillation). She highlights the importance of distinguishing between primary and secondary causes of instability before considering immediate cardioversion. Sara emphasizes that not all patients with A-Fib and low blood pressure require immediate intervention. Factors such as fluid status, electrolyte levels, and sympathetic activity should be evaluated to determine the underlying cause of instability. Sara advocates for a comprehensive approach that goes beyond the choice between beta blockers and calcium channel blockers. She introduces seven key questions to guide the management of Unstable A-Fib, including primary versus secondary causes, rate versus rhythm issues, the necessity of immediate cardioversion, electrolyte correction, fluid status assessment, and the use of appropriate medications. Sara suggests considering Amiodarone as a go-to option for rate and rhythm control in unstable A-Fib cases, while also addressing blood pressure support with medications like phenylephrine or vasopressin. Overall, this video provides valuable insights and strategies for effectively managing Unstable A-Fib.

00:04 Introduction to Unstable A-Fib

00:24 Understanding the Complexity of A-Fib

01:01 Broadening the Approach to A-Fib Treatment

01:47 Seven Questions to Guide A-Fib Treatment

01:59 Primary vs Secondary A-Fib

03:14 Case Study: Misdiagnosed A-Fib

04:03 Understanding the Role of Heart Rate in A-Fib

04:37 The Impact of Rhythm in A-Fib 07:06

The Role of Stress and Sympathetic Response in A-Fib

09:40 Importance of Correcting Electrolytes in A-Fib Treatment

10:57 Addressing Fluid Status in A-Fib Patients

11:56 Choosing the Right Drugs for A-Fib Treatment

14:13 Conclusion: A Comprehensive Approach to Unstable A-Fib

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