Prehospital rounds. Beyond SVT

This patient had a complex presentation, with many potential causes for his shock status. He was obviously in shock, with many signs of poor perfusion. He presented with very rapid heart and respiratory rates, and poor skin perfusion and oxygenation. The clinical presentation of the patient prompted the EMS crew to consider electrical cardioversion in hopes of addressing the unstable tachycardic rate. However, the crew opted to consider the patient's past medical history--i.e., the diarrhea, vomiting and lack of fluid intake--and instead treat the patient for hypovolemia. The picture had not improved by arrival at the ED, and had not been corrected with a fluid bolus.