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    ALS Algorithms LS Tachycardia 2.0

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    Lucian Alin Dinu
    1. This document provides guidance on assessing and treating tachycardia using the ABCDE approach, identifying and treating reversible causes, and determining appropriate treatment based on whether the tachycardia is stable or unstable, the QRS width, and rhythm regularity. 2. For unstable tachycardia with life-threatening features, the guidance is to give up to 3 synchronized shock attempts and if unsuccessful, consider sedation and medications like amiodarone or procainamide. 3. For stable tachycardia, the treatment approach differs based on whether the QRS is narrow or broad, and whether the rhythm is regular or irregular, with medications, cardioversion, or expert consultation recommended based on the

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    ALS Algorithms LS Tachycardia 2.0

    Uploaded by

    Lucian Alin Dinu
    259 views1 page
    1. This document provides guidance on assessing and treating tachycardia using the ABCDE approach, identifying and treating reversible causes, and determining appropriate treatment based on whether the tachycardia is stable or unstable, the QRS width, and rhythm regularity. 2. For unstable tachycardia with life-threatening features, the guidance is to give up to 3 synchronized shock attempts and if unsuccessful, consider sedation and medications like amiodarone or procainamide. 3. For stable tachycardia, the treatment approach differs based on whether the QRS is narrow or broad, and whether the rhythm is regular or irregular, with medications, cardioversion, or expert consultation recommended based on the

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    1. This document provides guidance on assessing and treating tachycardia using the ABCDE approach, identifying and treating reversible causes, and determining appropriate treatment based on whether the tachycardia is stable or unstable, the QRS width, and rhythm regularity. 2. For unstable tachycardia with life-threatening features, the guidance is to give up to 3 synchronized shock attempts and if unsuccessful, consider sedation and medications like amiodarone or procainamide. 3. For stable tachycardia, the treatment approach differs based on whether the QRS is narrow or broad, and whether the rhythm is regular or irregular, with medications, cardioversion, or expert consultation recommended based on the

    Copyright:

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

    ALS Algorithms LS Tachycardia 2.0

    Uploaded by

    Lucian Alin Dinu
    1. This document provides guidance on assessing and treating tachycardia using the ABCDE approach, identifying and treating reversible causes, and determining appropriate treatment based on whether the tachycardia is stable or unstable, the QRS width, and rhythm regularity. 2. For unstable tachycardia with life-threatening features, the guidance is to give up to 3 synchronized shock attempts and if unsuccessful, consider sedation and medications like amiodarone or procainamide. 3. For stable tachycardia, the treatment approach differs based on whether the QRS is narrow or broad, and whether the rhythm is regular or irregular, with medications, cardioversion, or expert consultation recommended based on the

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    of 1

    TACHYCARDIA

    Synchronised shock up to 3 attempts


    ASSESS with ABCDE approach
    Life-threatening features? • Sedation, anaesthesia if conscious
    • Give oxygen if SpO2 < 94% and obtain IV access
    1. Shock YES If unsuccessful:
    • Monitor ECG, BP, SpO2. Record 12 lead ECG
    2. Syncope
    • Identify and treat reversible causes
    • Amiodarone 300 mg IV over 10-20 min,
    or procainamide 10-15 mg/kg IV over 20
    UNSTABLE
    3. Myocardial ischaemia
    (e.g. electrolyte abnormalities, hypovolaemia min;
    4. Severe heart failure
    causing sinus tachycardia) • Repeat synchronised shock

    NO

    STABLE
    Is QRS narrow (<0.12 s)? SEEK EXPERT HELP

    Broad
    BroadQRS
    QRS Narrow QRS
    IsIsrhythm regular?
    QRS regular? Is QRS regular?

    Irregular Regular Regular Irregular

    Possibilities include:
    Vagal manoeuvres Probable atrial fibrillation:
    If VT (or uncertain rhythm):
    • Atrial fibrillation with bundle • Procainamide 10-15 mg/kg IV over 20 • Control rate with beta-blocker or
    branch block — treat as for irregu- min diltiazem
    lar narrow complex or If ineffective: • Consider digoxin or amiodarone if
    • Polymorphic VT • Amiodarine 300 mg IV over 10-60 min Adenosine (if no pre-excitation) evidence of heart failure
    (e.g. torsades de pointes) — give • 6 mg rapid IV bolus; • Anticoagulate if duration > 48h
    magnesium 2 g over 10 min • If unsuccessful give 12 mg
    If previous certain diagnosis of SVT
    • If unsuccessful give IV 18 mg
    with bundle branch block/
    aberrant conduction:
    • Treat as for regular narrow complex
    tachycardia If ineffective:
    • Verapamil or beta-blocker

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

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