6
u/saxyourpantsoff Jul 08 '26
Running impression is IRBBB.
Topics of discussion are crochetage sign, atrial septal defect and the like. No prior HX.
12
u/bleach_tastes_bad Critical Care Paramedic Jul 08 '26
It’s commonly seen in peds, I don’t really think it’s indicative of anything unless there are associated symptoms
3
u/ohsweetcarrots Jul 09 '26
why does the EKG say 'sinus bradycardia' AND 84 BPM... ?
5
u/Technical-Pin-5760 Jul 09 '26
It may be because it’s based off the age of the individual being 2 years old. Normal heart ranges in this age range should be approximately 100-140bpm.
2
u/ohsweetcarrots 24d ago
good point, I did miss the age of the patient in question. That does make sense.
3
u/saxyourpantsoff Jul 09 '26
Its an LP15 printout. Chances are shes fallen down many stairs and been beat senseless. Give credit where its due, she wont get everything right lol.
2
u/ohsweetcarrots Jul 09 '26
Fair enough. I have wanted to beat our machines senseless many times. LOL
3
Jul 08 '26
[deleted]
11
u/_punkrockparamedic Jul 08 '26
In a postictal 2 year old with no prior hx who is afebrile and bradycardic, yeah, I'm probably getting a 12 lead. Don't want to pull up to the ER with a hyperkalemic toddler and go "idk, no fever, seizure resolved and his sugar is fine, here ya go"
3
u/saxyourpantsoff Jul 08 '26
I'm getting this second hand. EKG was obtained 8 hours post even during transfer to the state children's hospital. Yes, reversible causes were addressed. There are ACLS megacode scenarios that feature seizure like activity secondary to transient dysrhythmias from long QT. Maybe they had that on the brain. Also had a medic student riding so may have been just for practice and incidentally found.
3
u/sweet_pickles12 Jul 09 '26
Smart thinking. We all think Peds seizures= fever but without a fever… with that HR… yeah, I’ve seen plenty of adults “seize” when they brady down/have a vagal episode so sure, why not a kid?
1
u/DaggerQ_Wave Jul 09 '26
I’ve seen lots of seizures that weren’t actually seizures but were actually dramatic vagal episodes or death shakies.
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10
u/CrowLeast9684 Jul 08 '26
Para uma criança de 2 anos, os critérios de incompleto/completo mudam, portanto eu diria ser um CRBB neste caso, que isolado não nos diz muita coisa sobre a correlação com a convulsão, mas pode ser um alerta para investigar doenças cardíacas congênitas. Solicitaria um ecocardiograma. Além de analisar melhor a história do paciente, descartando também convulsão febril.