A 58-year-old male is seen in the ED for syncope. His wife r…

A 58-year-old male is seen in the ED for syncope. His wife reports that she was in the kitchen when she heard him fall on the living room floor. He recalls feeling very lightheaded but remembers nothing more. Upon further questioning, he recalls feeling dizzy on several occasions over the past few months. He has a history of hypertension and a myocardial infarction 10 years earlier. He has since been well and exercises on a daily basis. In the ED, he has a blood pressure of 95/55 mmHg and a heart rate of 30 beats/min. An ECG is obtained (see the following ECG).  ECG1.jpg What is the most important initial step in managing this patient? 

A 24-year-old female presents to the ED with a complaint of,…

A 24-year-old female presents to the ED with a complaint of, “My heart is pounding out of my chest and I’ve been short of breath for 4 hours.” She has had similar episodes, but all have spontaneously stopped. She is in good health and takes no medications. Her blood pressure is 120/80 mmHg and pulse too rapid to count. Her rhythm is shown in the following ECG. ECG2.jpg What is the most appropriate immediate management for this patient?