----- Original Message -----
From: "Jonathan Benger"
Subject: Re: Pulseless VT
> On the other hand, in pulsed VT you have a lot more time to sort out the
> sync issue (and the complexes are usually readily recognisable by the
> average defib).
And not forgetting of course, that in "pulsed" VT you clearly must
synchronise, as a random shock could "convert" it to VF. But that's a good
point Jonathan, it takes time to sync and the machine may not be able to
sync at all. A further reason would be that unless the practitioner is used
to delivering sync shocks, they might think their machine's not working
properly, as you inevitably get a split-second delay after pressing the
buttons before the shock is delivered. This might put off the unwary (and
I've seen that happen). It comes back to the KISS principle (keep it simple
stupid) which is a sensible way to teach VF/VT management to all
practitioners, especially those who aren't cardiology SpRs! I think I would
have handled such a question by suggesting it would be just fine in his
hands but might cause temporary confusion or unnecessary delay in the hands
of a medical SHO, a CCU staff nurse, or a paramedic.
AF
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