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so, we all know in the treatment of AF with RVR, we want to be cautious about giving ionitropes (dilt especially). If the patient has NYC 3/4 HF, we want to avoid them.
So then, why does the ER throw dilt at everyone that walks in the door? I know I know, it's the ER, but I want to understand their mentality. If you don't know the patient, if you don't know whether or not they have HF (and to what extent, don't have a recent EF), wouldn't it be safer to avoid dilt at first, do amio instead? Or do nothing at all (if the patient is stable), wait for Cardiology, a formal TTE?
So then, why does the ER throw dilt at everyone that walks in the door? I know I know, it's the ER, but I want to understand their mentality. If you don't know the patient, if you don't know whether or not they have HF (and to what extent, don't have a recent EF), wouldn't it be safer to avoid dilt at first, do amio instead? Or do nothing at all (if the patient is stable), wait for Cardiology, a formal TTE?