adult tachycardia (with pulse) adult tachycardia (with pulse) secure patient airway, assist with...

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  • 2 Establish and Treat Possible Causes

    Adenosine 6 mg rapid IV push, follow with NS flush

    2nd Dose: 12 mg

    Adult Tachycardia (with Pulse)

    Secure patient airway, assist with respirations as needed Administer oxygen if hypoxic Attach cardiac monitor, monitor BP and SPO2

    1 Identify SVT (Heart rate >150)

    Synchronized Cardioversion Starting Doses:

    Antiarrhythmic Infusions (Stable Wide-Complex)

    Amiodarone: 150 mg over 10 min Repeat as necessary if VT recurs

    Procainamide: 20-50 mg/min until arrhythmia is suppressed, hypotension ensues, QRS duration increases >50%, or maximum dose of 17 mg/kg is reached

    Sotalol: 100 mg (1.5 mg/kg) over 5 min

    3 Hypotension? Shock?

    Ischemic Chest Pain? AMS?

    Heart Failure?

    4 QRS Wide? (> 0.12 sec)

    No

    5 Immediate Synchronized Cardioversion

    Yes

    If regular narrow complex, consider Adenosine

    _

    6 Establish vascular access Run 12-Lead ECG if possible Consider adenosine only if monomorphic and regular Consider antiarrhythmic infusion Seek expert consult

    7 Establish vascular access Run 12-Lead ECG if possible Consider vagal maneuvers Adenosine (if regular rhythm) Administer -Blocker or Calcium Channel Blocker Seek expert consult

    No

    Yes

    Narrow regular: 50-100 J Narrow irregular: 120-200 J biphasic or 200 J monophasic Wide regular: 100 J Wide irregular: defibrillation dose (Not synchronized)

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