A patient in the ED develops recurrent chest discomfort (8/10) suspicious for ischemia. His monitored rhythm becomes irregular as seen above. Oxygen is being administered by NC at 4 L/min and an IV line is patent. Bp is 160/96. There are no allergies or contraindications to any meds. You would first order:
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Amiodarone 150 mg IV
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Morphine sulfate 2-4 mg IV
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lidocaine 1 mg/kg and infusion 2 mg/min
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Nitroglycerin 0.4 mg SL
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IV nitroglycerine initiated at 10 ụg/min and titrated
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