Template:ACLS Wide Irregular Tachycardia: Difference between revisions
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*'''Unstable''': Hypotension, altered mental status, shock, ischemic chest discomfort, acute heart failure | *'''Unstable''': Hypotension, altered mental status, shock, ischemic chest discomfort, acute heart failure | ||
**[[Synchronized cardioversion]] 100-200J | **[[Synchronized cardioversion]] 100-200J | ||
#[[A fib]] with preexcitation | *'''Stable''': | ||
#*1st line - Electric [[Cardioversion]] | *#[[A fib]] with preexcitation | ||
#*2nd line - [[Procainamide]], [[amiodarone]], or [[sotalol]] | *#*1st line - Electric [[Cardioversion]] | ||
#[[A fib]] with aberrancy | *#*2nd line - [[Procainamide]], [[amiodarone]], or [[sotalol]] | ||
#Polymorphic [[V-Tach]] / [[Torsades De Pointes]] | *#[[A fib]] with aberrancy | ||
#*Give IV [[MgSO4]] | *#Polymorphic [[V-Tach]] / [[Torsades De Pointes]] | ||
#*Emergent defibrillation (NOT synchronized) | *#*Give IV [[MgSO4]] | ||
#*Correct [[electrolyte abnormalities]] (esp [[hypoK]], [[hypoMg]]) | *#*Emergent defibrillation (NOT synchronized) | ||
#*Stop [[prolonged QT]] meds | *#*Correct [[electrolyte abnormalities]] (esp [[hypoK]], [[hypoMg]]) | ||
*#*Stop [[prolonged QT]] meds | |||
Revision as of 10:57, 14 March 2018
ACLS: Wide Irregular Tachycardia
DO NOT use AV nodal blockers as they can precipitate V-Fib Pulseless: see Adult pulseless arrest
- Unstable: Hypotension, altered mental status, shock, ischemic chest discomfort, acute heart failure
- Synchronized cardioversion 100-200J
- Stable:
- A fib with preexcitation
- 1st line - Electric Cardioversion
- 2nd line - Procainamide, amiodarone, or sotalol
- A fib with aberrancy
- Polymorphic V-Tach / Torsades De Pointes
- Give IV MgSO4
- Emergent defibrillation (NOT synchronized)
- Correct electrolyte abnormalities (esp hypoK, hypoMg)
- Stop prolonged QT meds
- A fib with preexcitation