Department of Emergency Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, United States of America.
Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, United States of America.
Am J Emerg Med. 2020 Jul;38(7):1481-1487. doi: 10.1016/j.ajem.2020.04.017. Epub 2020 Apr 10.
Electrical storm is a dangerous condition presenting to the Emergency Department that requires rapid diagnosis and management.
This article provides a review of the diagnosis and management of electrical storm for the emergency clinician.
Electrical storm is defined as ≥3 episodes of sustained ventricular tachycardia, ventricular fibrillation, or shocks from an implantable cardioverter defibrillator within 24 h. Patients may present with a wide array of symptoms. Initial evaluation should include an electrocardiogram with a rhythm strip and continuous cardiac monitoring, a medication history, assessment of hemodynamic stability, and identification of potential triggers. Management includes an antiarrhythmic and a beta blocker. Refractory patients may benefit from double-sequential defibrillation or more invasive procedures such as intra-aortic balloon pumps, catheter ablation and extracorporeal membrane oxygenation for critically ill patients. These patients will typically require admission to an intensive care unit.
Electrical storm is a condition associated with significant morbidity and mortality. It is important for clinicians to be aware of the current evidence regarding the evaluation and management of these patients.
电风暴是一种危险的病症，会到急诊就诊，需要快速诊断和处理。
本文为急诊临床医生提供了电风暴的诊断和处理综述。
电风暴定义为 24 小时内≥3 次持续的室性心动过速、心室颤动或来自植入式心律转复除颤器的电击。患者可能表现出广泛的症状。初始评估应包括心电图和节律带以及连续心脏监测、药物史、血流动力学稳定性评估和潜在诱因的识别。治疗包括抗心律失常药物和β受体阻滞剂。难治性患者可能受益于双相顺序除颤或更具侵入性的程序，如主动脉内球囊泵、导管消融和体外膜氧合，适用于重症患者。这些患者通常需要入住重症监护病房。
电风暴是一种与显著发病率和死亡率相关的病症。临床医生了解这些患者的评估和处理的当前证据非常重要。
