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Old 06-15-2013, 13:15   #32
Trapper John
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Join Date: Nov 2012
Location: Harrisburg, PA
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The T-waves in this patient are highly irregular. May be fused P waves or U waves or both. Definitely not hyperkalemia. May be hypokalemia. Has the patient been having diarrhea? On diuretics?

May also be fused P wave and now were back to BrushOkie's heart block (probably Stage 1).

What are the chances of both hypokalemic and stage 1 heart block?

Will IV KCL (bolus, 1100 mg) be differentiating? If so I would monitor the T waves to see if a normal T wave appears. If not then we may be dealing with heart block and IV lidocaine (50 mg IV bolus) would be indicated.

I am still leaning more towards AF with hypokalemia.
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