When a patient has a new finding of Atrial Fibrillation (Afib), or if chronic atrial fibrillation is now not controlled, notifying the provider is required. When making the call, you will need to provide several data points to determine what treatment will be necessary. Being prepared is key to helping this patient! The following is a list of what is needed, and we call it The Afib Package.
Advanced Care of Acute Changes
Atrial Fibrillation/Arrhythmia
STEP 1 Assess Patient and Gather Information – Gather Afib Package
Afib Package
Patient Information
Surgical information: Operation, ablation?, L atrial appendage clip?
Rhythm verified by rhythm strip/EKG?
How long since onset
Heart Rate – current and prior to onset
Blood Pressure – current and prior to onset, manual vs automatic
SaO2, O2 setting
Symptoms – change in mentation, chest pressure, dizziness, etc
Medications/drips – current vasoactive medication, anticoagulation, times given, and home doses
History of Afib – first episode, recurrent, chronic
Is Cardiology team already involved?
Any other relevant findings/information
STEP 2 Communication – Send Telemediq page to team
Template for the Telemediq page (adapt text in red to your patient)
Patient in ____ is now in atrial fibrillation/new arrhythmia, please call back at ____-_____.
Template for the Conversation (Phone call/In person)
This is _________ calling about patient in _____ who is a 65y/o male postop day 3 from VATS with an acute change of new onet atrial fibrillation since 12:15, verified on rhythm strip/EKG.
The HR is now 140, and previously was 80. The BP is 106/60 manually taken, before onset was 124/70.
She complains of chest tightness/is asymptomatic.
She is on PO metoprolol 25mg BID, last dose was 17:00, and amiodarone 400 bid, is not on anticoagulation.
She has no history of atrial fibrillation and has not been seen by cardiology.
STEP 3 Follow up – As needed, communicate any further changes
(i.e If new clinical change, or cannot carry out orders, send Telemediq page again)
Template for follow-up Telemediq page
This is _________ calling about patient in _____, heart rate is now 100 and sinus rhythm, or barriers to starting ordered treatment, etc, Call back number is ____-_____.