Really, no really, wide QRS complexes

Dr. Mattu reminds us of our differential for really wide QRS complexes, also quick approach to TCA overdose treatment.

Wide QRS

• Ventricular ectopy
  
• Paced Beats
  
• BBB
  
• WPW syndrome
  
• Non Specific IVCD
  
• Medication toxicity (NaCB)
  
• Metabolic

Tips to identifying TCA on ECG

• Wide complex tachy, esp if QRS >200ms
• Right Axis Deviation
  • Tall R in aVR
• New onset seizures

Copa Cardiogram #62