Reader Submission by Adena Homnick, RPA-C,
MPAS
A 60-year-old man is found by paramedics,
unresponsive, in an alley just outside a liquor store. The patient is brought
to the trauma center with severe neurologic impairment and evidence of facial
trauma.
Vital signs include a heart rate of 51 beats/min;
blood pressure, 110/60 mm Hg; respiratory rate, 13 breaths/min; and rectal
temperature, 26.5°C (79.7°F).
An ECG, obtained after the patient has been
intubated, shows the following: a ventricular rate of 51 beats/min; PR
interval, 134 ms; QRS duration, 94 ms; QT/QTc interval, 552/508 ms; P axis,
45°; R axis, 86°; and T axis, 94°. Besides bradycardia, what abnormality is
present?
