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Tachycardia Algorithm 2021

1. This document provides an algorithm for assessing and treating adult tachycardia. It involves taking vital signs and a 12-lead ECG to identify any life-threatening features or reversible causes. 2. If life-threatening features are present, the first treatment is a synchronized DC shock. If that is unsuccessful, amiodarone or repeated shocks are options. 3. If stable, the algorithm assesses QRS width to determine a narrow or broad complex tachycardia. It then evaluates regularity to determine specific treatment options which may include vagal maneuvers, medications like adenosine, or synchronized shocks.

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Ravin Debie
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632 views1 page

Tachycardia Algorithm 2021

1. This document provides an algorithm for assessing and treating adult tachycardia. It involves taking vital signs and a 12-lead ECG to identify any life-threatening features or reversible causes. 2. If life-threatening features are present, the first treatment is a synchronized DC shock. If that is unsuccessful, amiodarone or repeated shocks are options. 3. If stable, the algorithm assesses QRS width to determine a narrow or broad complex tachycardia. It then evaluates regularity to determine specific treatment options which may include vagal maneuvers, medications like adenosine, or synchronized shocks.

Uploaded by

Ravin Debie
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Adult tachycardia

Assess with Life threatening Synchronised DC


YES
ABCDE approach features? shock
• Give oxygen if SpO2 < 94% up to 3 attempts
1. Shock
• Obtain IV access • Sedation or anaesthesia if
• Monitor ECG, BP, SpO2, 2. Syncope conscious
record 12-lead ECG 3. Myocardial If unsuccessful:
• Identify and treat reversible causes ischaemia • Amiodarone 300 mg IV
e.g. electrolyte abnormalities, over 10–20 min
hypovolaemia causing sinus 4. Severe heart
• Repeat synchronised DC
tachycardia failure shock

UNSTABLE

STABLE
Seek expert help
NO

Is the QRS narrow (< 0.12 s)?

BROAD QRS NARROW QRS


Is QRS regular? Is QRS regular?

IRREGULAR REGULAR REGULAR IRREGULAR

Possibilities If VT (or uncertain Vagal Probable atrial


include: rhythm): manoeuvres fibrillation:
• Atrial fibrillation with • Amiodarone 300 mg IV • Control rate with
bundle branch block over 10–60 min beta-blocker
treat as for irregular If ineffective: • Consider digoxin or
narrow complex If previous certain
diagnosis of SVT with • Give Adenosine amiodarone if evidence
• Polymorphic VT bundle branch block/ (if no pre-excitation) of heart failure
(e.g. torsades de pointes) aberrant conduction: – 6 mg rapid IV bolus • Anticoagulate if
give magnesium 2 g duration > 48 h
over 10 min • Treat as for regular – If unsuccessful,
narrow complex give 12 mg
tachycardia – If unsuccessful,
give 18 mg
• Monitor ECG
continuously

If ineffective:
• Verapamil
or beta-blocker

If ineffective:
• Synchronised DC shock up to 3 attempts
• Sedation or anaesthesia if conscious

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