Interpretation
The information we are given tells us that this is a probable overdose, but don’t be limited to just that. The important thing to pick up is that the patient is now hypotensive.
Rate: 120
Axis: Normal
P waves: Very difficult to see, although in aVF, there may be some there.
QRS: Widened, with abnormal deep Qs anteriorly- consider LBBB
ST-T:Peaked T waves
PR/QT Int: Prolonged QT
This is a broad complex, somewhat bizarre tachycardia with peaked T waves. Taken with the history, the main causes to consider are tricyclic overdose, or other Na channel blockers and hyperkalaemia.
This patient requires a resuscitation cubicle and monitoring. Bloods for BSL, K, renal function, (you can do a troponin, however unlikely in a 30 year old female).
Treat early- Bizarre ECG = Bicarbonate.
Early treatment of bicarb 1mmol/kg.
Beware as this patient is prone to seizures with the QRS prolongation present.
Consider early definitive airway management.
