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    Tachycardia Algorithm

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    Gideon Bahule
    This document provides an algorithm for managing tachycardia. It outlines assessing the airway, breathing, circulation and attaching monitoring equipment. For stable narrow complex tachycardia, it recommends vagal maneuvers or adenosine. For unstable or wide complex tachycardia, it suggests amiodarone, cardioversion or magnesium depending on the rhythm. It provides pediatric dosage guidelines.

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    Download as PDF, TXT or read online from Scribd

    Tachycardia Algorithm

    Uploaded by

    Gideon Bahule
    37 views1 page
    This document provides an algorithm for managing tachycardia. It outlines assessing the airway, breathing, circulation and attaching monitoring equipment. For stable narrow complex tachycardia, it recommends vagal maneuvers or adenosine. For unstable or wide complex tachycardia, it suggests amiodarone, cardioversion or magnesium depending on the rhythm. It provides pediatric dosage guidelines.

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    This document provides an algorithm for managing tachycardia. It outlines assessing the airway, breathing, circulation and attaching monitoring equipment. For stable narrow complex tachycardia, it recommends vagal maneuvers or adenosine. For unstable or wide complex tachycardia, it suggests amiodarone, cardioversion or magnesium depending on the rhythm. It provides pediatric dosage guidelines.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    37 views1 page

    Tachycardia Algorithm

    Uploaded by

    Gideon Bahule
    This document provides an algorithm for managing tachycardia. It outlines assessing the airway, breathing, circulation and attaching monitoring equipment. For stable narrow complex tachycardia, it recommends vagal maneuvers or adenosine. For unstable or wide complex tachycardia, it suggests amiodarone, cardioversion or magnesium depending on the rhythm. It provides pediatric dosage guidelines.

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    © All Rights Reserved
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    TACHYCARDIA MANAGEMENT

    ALGORITHM
    AIRWAY
    Open, maintain and protect as necessary
    2015 2015

    BREATHING
    Administer oxygen if required. Target Saturation 94 - 98%
    Ventilate if necessary

    CIRCULATION
    Assess pulse, blood pressure and
    perfusion
    Attach ECG monitor, pulse oximeter
    and vital signs monitor if available

    DRIP
    Establish IV access

    ECG RHYTHM
    Run rhythm strip to confirm dysrhythmia SPECIALIST MEDICAL ADVICE
    12 lead ECG if possible SHOULD BE SOUGHT
    Identify and treat underlying causes WHENEVER POSSIBLE

    SIGNS OF INSTABILITY
    • Hypotension
    • Acutely altered mental state
    • Signs of shock
    • Ischaemic chest discomfort
    • Acute heart failure

    TACHYCARDIA
    HR > 150/min * See Paed Rates

    STABLE UNSTABLE SYNCHRONISED


    NARROW COMPLEX
    TACHYCARDIA CARDIOVERSION
    (Supraventricular Tachycardia) Consider procedural sedation
    HR > 150/min with QRS < 0.12 sec
    Start with 100J initially
    WIDE COMPLEX (monophasic or biphasic)
    VAGAL STIMULATION
    TACHYCARDIA
    (NOT if varying R-R intervals / Paediatric start 0.5 - 1J/kg
    (Ventricular Tachycardia)
    Atrial fibrillation) then 2J/kg (Max 4J/kg)
    Generally HR > 150/min with
    Preferable: Valsalva (Modified)
    QRS > 0.12 sec
    Alternatives
    Ice water applied to face AMIODARONE
    Coughing / Breath-holding 150 mg in 5% D/W over * Paediatric Tachycardia Rates
    Carotid Sinus Massage (C/I if bruits, 10min IV (15 mg / min), QRS < 0.08sec
    CVS disease, elderly) then 1 mg / min infusion
    ADENOSINE Consider (if Torsades de Pointes): QRS > 0.08 sec
    (NOT if varying R-R intervals / • Defibrillation (Asynchronous)
    Atrial fibrillation) • Magnesium (2g IV over 10min) Paediatric Drug Doses
    Adenosine 0.1mg / kg rapidly
    6 mg IV rapidly, then 12mg IV • Correct Electrolytes and consider
    followed by 0.2mg / kg
    after 1 - 2min prn toxins/drugs
    Alternatives Amiodarone 5mg / kg
    over 20 - 60min (max 300mg)
    (esp irregular rhythms)
    • BB or CCB Magnesium 50 mg / kg

    AMIODARONE
    150 mg in 5% D/W over 10 minutes
    IV (15 mg/min) then 1 mg/min infusion

    Alternatives
    (esp irregular rhythms)
    • BB or CCB * BB = Beta Blockers
    * CCB = Calcium Channel Blockers

    www.resuscitationcouncil.co.za

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