Received Mar 5, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| TDAP | TDAP (BOOSTRIX) | GLAXOSMITHKLINE BIOLOGICALS | UNK | PF44A | LA |
| VARZOS | ZOSTER (SHINGRIX) | GLAXOSMITHKLINE BIOLOGICALS | UNK | 72R4G | IM / RA |
Patient seen in Emergency Dept. on 2/6/26 for Persistent atrial fibrillation. 02/06/26 0954 131/119 180 Additional ED course the patient was intolerant of the electrical cardioversion which was attempted twice. I gave him several doses of diltiazem boluses which brought his heart rate down into the 120 range but then it climbed back up and was requiring an diltiazem infusion. Ultimately this patient will need to have cardiology services and electrophysiology services. In communication with the patient the initial hospitals that he would like to be transferred to had no beds but ultimately his wife has worked at [withheld name] Hospital and they were accepting of that hospital for transfer into the patient was transferred in guarded condition. ED Course as of 02/11/26 0528 Fri Feb 06, 2026 1129 Sedation Procedure Note Indication: Cardioversion ASA class: [___Normal] Medication/Dose: Etomidate and fentanyl see nurses notes Sedation time: 45 minutes Level of sedation: Deep Estimated Blood Loss: None Specimens Removed: None Verbal consent was obtained, including a discussion of the risks and benefits, from the responsible party. Patient was monitored throughout the procedure with continuous pulse oximetry, cardiac monitoring, intermittent blood pressure, and end-tidal capnography. There was no hemodynamic or respiratory compromise. An independent, trained observer was available throughout the procedure to monitor the patientâ s level of consciousness and physiological status. Patient was observed until back to baseline neurologic status prior to discharge. 1129 Cardioversion was performed during sedation. It was biphasic 200 J synchronized. Pads were front and back. Initial cardioversion demonstrated an improvement in heart rate but then the patient immediately increase his heart rate back up to 160-170 and atrial fibrillation with rapid ventricular response. I repeat cardioversion was again performed biphasic 200 J synchronized under sedation. This to resulted in no improvement in his heart rate. 1130 After 2 failed attempts at cardioversion electrically I gave a dose of IV diltiazem and it resulted in his heart rate going to 120 but still in A-fib. To bring his heart rate to less than 100 I gave him his second dose of diltiazem. He was also given a dose of Lovenox. 1338 Due to no availability in any Intermountain facility that has cardiology services I transferred to [withheld name] hospital. DISPOSITION: Transfered to Another Facility
unknown
Anxiety, ED, BMI 32.0-32.9 adult, Dysthumic disorder
QUEtiapine 25mg , sildenafil20mg, zolpidem 10mg
none reported.