Restore Sinus Rhythm in Disoriented Patients

February 17, 2012

Is a patient's disorientation associated with arrhythmia?

Before concluding that a disoriented patient has a mental problem, check the ECG.

I recently saw a confused, combative man rapid pulse attributed to overexertion. The ECG showed atrial flutter with a heart rate of 150 beats per minutes. When sinus rhythm was restored with 50 watt-seconds of synchronized DC countershock, the cerebral anoxia associated with the arrhythmia cleared, and the man became quite calm.