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Adult Tachycardia With A Pulse Algorithm: Doses/Details

The document provides an algorithm for treating adult tachycardia with a pulse. It outlines steps to identify the underlying cause, assess the patient's condition, and determine appropriate treatment which may include synchronized cardioversion, antiarrhythmic drug infusions, or expert consultation depending on factors like heart rate, symptoms, and ECG findings.

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Alexis Hospital
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716 views1 page

Adult Tachycardia With A Pulse Algorithm: Doses/Details

The document provides an algorithm for treating adult tachycardia with a pulse. It outlines steps to identify the underlying cause, assess the patient's condition, and determine appropriate treatment which may include synchronized cardioversion, antiarrhythmic drug infusions, or expert consultation depending on factors like heart rate, symptoms, and ECG findings.

Uploaded by

Alexis Hospital
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 With a Pulse Algorithm

Assess appropriateness for clinical condition. Doses/Details


Heart rate typically ≥150/min if tachyarrhythmia. Synchronized cardioversion:
Refer to your specific device’s recommended energy level to
maximize first shock success.
Adenosine IV dose:
First dose: 6 mg rapid IV push; follow with NS flush.
Second dose: 12 mg if required.
Identify and treat underlying cause Antiarrhythmic Infusions for Stable Wide-QRS Tachycardia
• Maintain patent airway; assist breathing as necessary Procainamide IV dose:
• Oxygen (if hypoxemic) 20-50 mg/min until arrhythmia suppressed, hypotension ensues,
• Cardiac monitor to identify rhythm; monitor blood QRS duration increases >50%, or maximum dose 17 mg/kg given.
pressure and oximetry Maintenance infusion: 1-4 mg/min. Avoid if prolonged QT or CHF.
• IV access
Amiodarone IV dose:
• 12-lead ECG, if available
First dose: 150 mg over 10 minutes. Repeat as needed if VT recurs.
Follow by maintenance infusion of 1 mg/min for first 6 hours.
Sotalol IV dose:
100 mg (1.5 mg/kg) over 5 minutes. Avoid if prolonged QT.

Persistent
tachyarrhythmia causing:
Synchronized cardioversion
• Hypotension? Yes
• Acutely altered mental status? • Consider sedation
• Signs of shock? • If regular narrow complex, If refractory, consider
• Ischemic chest discomfort? consider adenosine
• Underlying cause
• Acute heart failure?
• Need to increase
energy level for next
No cardioversion
• Addition of anti-
Yes Consider arrhythmic drug
Wide QRS?
• Adenosine only if • Expert consultation
≥0.12 second
regular and monomorphic
• Antiarrhythmic infusion
No • Expert consultation

• Vagal maneuvers (if regular)


• Adenosine (if regular)
• β-Blocker or calcium channel blocker
• Consider expert consultation
© 2020 American Heart Association

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