Wolff Parkinson White (WPW) syndrome: what the critical care nurse needs to consider when administering antiarrhythmics.
This paper discusses the importance of critical care and emergency nurses having an understanding of why pre-existing cardiac disorders can influence antiarrhythmic treatment. The patient with a pre-excitation syndrome is usually managed in a coronary care unit. However, these patients may be admitted to an intensive care unit (ICU) with complications of Wolff Parkinson White (WPW) syndrome; for example post cardiopulmonary arrest or WPW as a co-morbidity. It is common practice in critical care areas for registered nurses to administer antiarrhythmics without a doctor's prescription in life-threatening situations. Therefore, the critical care nurse must have knowledge of the implications of administering standard antiarrhythmic agents if this patient reverts into a tachyarrhythmia. If antiarrhythmics are administered that are contraindicated in patients with WPW syndrome, then there is potential for deleterious effects. This case study highlights the different pharmacological agents for treating tachyarrhythmias in a patient with WPW syndrome. The paper outlines the correct treatment and discusses the deleterious effects of incorrect administration of drugs in WPW syndrome.
Evans-Murray
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Critical Care Division, Gold Coast Hospital/Griffith University, QLD.
D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D000075202:Contraindications; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D013617:Tachycardia, Supraventricular / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications* / Q000451:nursing / Q000503:physiopathology
D000889:Anti-Arrhythmia Agents