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    1) Tachycardia, or abnormally fast heart rate, can be caused by various reversible factors like hypoxia, hypovolemia, electrolyte imbalances, or toxins. 2) The ECG should be monitored to identify the rhythm and determine if it is narrow or wide complex. 3) Treatment depends on rhythm and stability of the patient, and may include vagal maneuvers, medications like adenosine or amiodarone, synchronized cardioversion, or expert consultation. The underlying cause should also be treated.

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    SVT

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    1) Tachycardia, or abnormally fast heart rate, can be caused by various reversible factors like hypoxia, hypovolemia, electrolyte imbalances, or toxins. 2) The ECG should be monitored to identify the rhythm and determine if it is narrow or wide complex. 3) Treatment depends on rhythm and stability of the patient, and may include vagal maneuvers, medications like adenosine or amiodarone, synchronized cardioversion, or expert consultation. The underlying cause should also be treated.

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    6 views1 page

    .JPG 958×1,280 Pixels

    Uploaded by

    yordanos getachew
    1) Tachycardia, or abnormally fast heart rate, can be caused by various reversible factors like hypoxia, hypovolemia, electrolyte imbalances, or toxins. 2) The ECG should be monitored to identify the rhythm and determine if it is narrow or wide complex. 3) Treatment depends on rhythm and stability of the patient, and may include vagal maneuvers, medications like adenosine or amiodarone, synchronized cardioversion, or expert consultation. The underlying cause should also be treated.

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    of 1

    TACHYCARDIA

    WithPulses

    •AssessandsupportABCsasneeded
    Giveoxygen
    •MonitorECG(identifyrhythm),bloodpressure,oximetry
    Identifyandtreatreversiblecauses

    SymptomsPersist Performimmediate
    synchronizedcardioversion
    EstablishIVaccess Ispatientstable? •EstablishIVaccessandgive
    •Obtain12-leadECG Stable Unstablesignsincludealtered Unstable sedationifpatient
    (whenavailable) mentalstatus,ongoingchestpain, isconscious;donotdelay
    orrhythmstrip hypotensionorothersignsofshock cardioversion
    IsQRSnarrow(<0.12sec)? Note:rate-relatedsymptoms •Considerexpertconsultation
    uncommonifheartrate<150/min Ifpulselessarrestdevelops,
    seePulselessArrestAlgorithm

    Wide(≥0.12sec)
    Narrow
    12

    NARROWQRS*: WIDEQRS*:
    IsRhythmRegular? IsRhythmRegular?
    Expertconsultation
    Regular Irregular advised
    11

    •Attemptvagalmaneuvers IrregularNarrow-Complex Regular Irregular


    •Giveadenosine6mgrapid Tachycardia 13 14
    IVpush.Ifnoconversion, Probableatrialfibrillationor
    give12mgrapidIVpush; possibleatrialflutterorMAT Ifventricular Ifatrialfibrillationwith
    mayrepeat12mgdoseonce (multifocalatrialtachycardia) tachycardiaor aberrancy
    •Considerexpertconsultation uncertainrhythm •SeeIrregularNarrow-
    Controlrate(eg,diltiazem, •Amiodarone ComplexTachycardia
    B-blockers;use-blockerswith 150mgIVover10min (Box11)
    Doesrhythm cautioninpulmonarydisease Repeatasneeded
    convert? orCHF) tomaximumdoseof Ifpre-excitedatrial
    Note:Consider 2.2g/24hours fibrillation(AF+WPW)
    expertconsultation •Prepareforelective •Expertconsultation
    synchronized advised
    Converts DoesNotConvert cardioversion •AvoidAVnodal
    blockingagents(eg,
    9 10 IfSVTwithaberrancy adenosine,digoxin,
    Ifrhythmconverts,
    •Giveadenosine diltiazem,verapamil)
    IfrhythmdoesNOTconvert, •Considerantiarrhyth-
    (gotoBox7)
    probablereentrySVT possibleatrialflutter,
    mics(eg,amiodarone
    (reentrysupraventricular ectopicatrialtachycardia,
    tachycardia): orjunctionaltachycardia: 150mgIVover10min)
    •Observeforrecurrence •Controlrate(eg,diltiazem, Ifrecurrentpolymor-
    phicVT,seekexpert
    •Treatrecurrencewith B-blockers:useB-blockerswith
    consultation
    adenosineorlonger- cautioninpulmonarydisease
    actingAVnodalblocking orCHF) Iftorsadesdepointes,
    agents(eg,diltiazem. Treatunderlyingcause givemagnesium
    B-blockers) •Considerexpertconsultation (loadwith1-2gover
    5-60min,theninfusion)

    DuringEvaluation Treatcontributingfactors:
    •Secure,verifyairway -Hypovolemia -Toxins
    *Note:Ifpatientbecomes andvascularaccess -Hypoxia -Tamponade,cardiac
    unstable,gotoBox4. whenpossible -Hydrogenion(acidosis) -Tensionpneumothorax
    •Considerexpert -Hypo-/hyperkalemia •Thrombosis(coronaryor
    consultation -Hypoglycemia pulmonary)
    Preparefor -Hypothermia -Trauma(hypovolemia)
    cardioversion

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