Implantable cardioverterdefibrillators: a case report

Implantable cardioverter-defibrillators (ICDs) are devices placed into patients with a variety of cardiac conditions to prevent sudden death from dysrhythmias. On occasion, these devices can malfunction, presenting a challenge to both prehospital and emergency department providers. In this article, we present a case in which pre-hospital providers encountered a patient whose ICD was firing continuously in a patient with sustained ventricular tachycardia. We then discuss the prehospital management of patients whose ICDs have fired. Scenarios discussed include management of the single appropriate ICD shock, management of multiple appropriate ICD shocks, and management of inappropriate ICD shocks.

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