Advanc

edCardi
ovascul
arLi
feSuppor
t
Savi
ngLi
vesToget
her
Adul
tTachyc
ardi
awithaPuls
e

Assessi
fthehear
trhyt
hm i
sappr
opr
iat
efort
hepat
ient
’
scondi
t
ion.
Hear
trat
esabove150beat
spermi
nut
e(bpm)shoul
dgener
all
ybet
reat
ed.

Sear
chf
orandt
reatt
hecause.
Moni
tor
: Pr
ovi
deasneeded:
Per
for
m synchr
oni
zedcar
diover
sion:
•Hear
trhyt
hm •Mai
ntai
nanopenai
rway
st
artwi
th:
•Oxymet
ry •Gi
veoxygen
Nar
rowr
egul
ar:gi
ve50-
100J.
•Bl
oodpr
essur
e
Nar
rowi
rr
egul
ar:gi
ve120-
200Jbi
phasi
c
or200Jmonophasi
c.
Wi
der
egul
ar:gi
ve100J.
Wi
dei
rr
egul
ar:def
i
bri
l
lat
e
I
stheTachyar
rhyt
hmi
a (
notsyncr
oni
zed)
.
per
sist
antandsympt
omat
ic? Consi
derpr
ovi
dingsedat
i
on.
•Lowbl
oodpr
essur
e Forr
egul
arnar
rowcompl
ex:
Wi
deQRScompl
ex≥0.
12seconds No Yes
•Changei
nment
alst
atus consi
dergi
vi
ngadenosi
ne.
•Chestpai
n 1stdose:6mgI
V/I
O pushwi
thNSf
lush.
•Hear
tfai
l
ure 2nddose:12mgI
V/I
O pushwi
thNSf
lush.

Yes No

Pr
ovi
deI
Vac
ces
s. Consi
dergi
vi
ngcal
ci
um channelbl
ocker
s.
Obt
aina12-
lea
dECGi
fava
il
abl
e. Consi
dergi
vi
ngbet
abl
ocker
s.
Per
for
m vega
lma
neuver
s. Consi
derr
equest
ingexper
tconsul
tat
ion.
I
frhy
thmi
sre
gul
ar:
Gi
vea
denos
ine.
1stdose:6mgI
V/I
O pushwi
t
hNSf
l
ush.
2nddose:12mgI
V/I
O pushwi
thNSf
l
ush.

Pr
ovi
deI
Vaccess. I
fther
eisnopr
olongedQTorCHF: Consi
dergi
vi
ngami
odar
one.
Obt
aina12-
leadEKG i
favai
l
abl
e. Consi
derapr
ocai
nami
dei
nfusi
on. 1stdose:150mgI
V/I
O over10mi
nut
es.
I
frhyt
hm i
sregul
arandmonomor
phi
c: I
nfuseat20-
50mg/
minI
V/I
O wi
t
ha Repeati
fVTr
eocur
rs.
Gi
veadenosi
ne. maxi
mum doseof17mg/
kg. Fol
l
owwi
thamai
ntenancei
nfusi
on:
1stdose:6mgI
V/I
O pushwi
t
hNSf
l
ush. cont
inuepr
ocai
nami
dei
nfusi
onunt
il
: 1mg/
minf
orf
oll
owi
ng6hour
s.
2nddose:12mgI
V/I
O pushwi
thNSf
lush. •r
hyt
hm conver
ts. I
fther
eisnopr
olongedQT:
•admi
nist
rat
i
onr
esul
t
sinhypot
ent
i
on. Consi
dergi
vi
ngSot
alol
:
•QRScompl
exdur
ati
onr
ises>50%. I
nfuse100mg(
1.5mg/
kg)I
V/I
O over5mi
nut
es.
Mai
ntenancei
nfusi
onr
atei
s1-
4mg/
min. Consi
derr
equest
ingexper
tconsul
tat
i
on.

Source:AmericanHeartAssociat
ion.(2015)
.
ht
tps:/
/eccgui
deli
nes.
heart.
org/
wp- cont
ent/
upl
oads/
2015/
10/
2010-
Int
egr
ated_Updat
ed-
Cir
cul
ati
on-
ACLS-
Tachycar
dia-
Algor
it
hm.
png
Dall
as,TX:Publ i
sher
.
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edMedi calEducat
ion2017