Recurrent asystole associated with vasovagal reaction during venipuncture.
A patient with a documented history of 2 asystolic episodes associated with venipuncture demonstrates the profound cardioinhibitory effects that vasovagal reactions to blood and injury ("blood-injury phobia") can produce. In approaching a patient with blood-injury phobia, the clinician should place the patient in the Trendelenburg position, apply a cardiac monitor, administer oxygen, and consider the need for atropine, transcutaneous pacing, and cough cardiopulmonary resuscitation (CPR) prior to venipuncture. Diagnosis of vasovagal syncope is discussed. Long-term prophylactic interventions may be beneficial for certain patients.
Lipton
J D
JD
Department of Emergency Medicine, Carolinas Medical Center, Charlotte, North Carolina.
Forstater
A T
AT
D000328:Adult; D001285:Atropine / Q000627:therapeutic use; D001815:Bloodletting / Q000009:adverse effects*; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D004562:Electrocardiography; D004635:Emergency Medicine; D006323:Heart Arrest / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D010698:Phobic Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D012008:Recurrence; D013575:Syncope / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D014630:Vagus Nerve
D001285:Atropine