PALS: Tachycardia: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - " w/ " to " with ") |
ClaireLewis (talk | contribs) No edit summary |
||
| (8 intermediate revisions by 2 users not shown) | |||
| Line 1: | Line 1: | ||
''This page is for <u>pediatric</u> patients; for adult patients see [[ACLS: Tachycardia]]'' | |||
==Background== | ==Background== | ||
*Algorithm assumes pulse and adequate perfusion | *Algorithm assumes pulse and adequate perfusion | ||
==Narrow-Complex== | ==[[narrow complex tachycardia|Narrow-Complex]]== | ||
===[[Sinus tachycardia]]=== | |||
*Treat underlying cause | |||
==Wide-Complex== | ===[[SVT|Supraventricular]]=== | ||
*Adenosine for differentiating SVT from | *[[Vagal stimulation]] (if will not delay medications/cardioversion) | ||
**Infants/young children: apply ice to face | |||
**Older children: Carotid sinus massage / [[valsalva maneuver|Valsalva]] | |||
*[[Synchronized cardioversion]] | |||
**Use if unstable or [[adenosine]] ineffective | |||
**Give 0.5-1 J/kg; if unsuccessful increase to 2 J/kg | |||
***Give 2nd shock consider [[amiodarone]] OR [[procainamide]] before 3rd shock | |||
****[[Amiodarone]] 5mg/kg over 20-60min | |||
****[[Procainamide]] 15mg/kg over 30-60min | |||
*[[Adenosine]] | |||
**0.1mg/kg; immediately flush with 5cc normal saline | |||
==[[wide complex tachycardia|Wide-Complex]]== | |||
*[[Adenosine]] for differentiating [[SVT]] from [[ventricular tachycardia]] | |||
**Consider only if rhythm is regular and QRS monomorphic | **Consider only if rhythm is regular and QRS monomorphic | ||
*Synchronized cardioversion | *[[Synchronized cardioversion]] | ||
**Give 0.5-1 J/kg; if unsuccessful increase to 2 J/kg | **Give 0.5-1 J/kg; if unsuccessful increase to 2 J/kg | ||
**Give 2nd shock consider amiodarone OR procainamide before 3rd shock | **Give 2nd shock consider [[amiodarone]] OR [[procainamide]] before 3rd shock | ||
***Amiodarone | ***[[Amiodarone]] 5mg/kg over 20-60min | ||
***Procainamide | ***[[Procainamide]] 15mg/kg over 30-60min | ||
==See Also== | ==See Also== | ||
Latest revision as of 19:28, 6 October 2019
This page is for pediatric patients; for adult patients see ACLS: Tachycardia
Background
- Algorithm assumes pulse and adequate perfusion
Narrow-Complex
Sinus tachycardia
- Treat underlying cause
Supraventricular
- Vagal stimulation (if will not delay medications/cardioversion)
- Infants/young children: apply ice to face
- Older children: Carotid sinus massage / Valsalva
- Synchronized cardioversion
- Use if unstable or adenosine ineffective
- Give 0.5-1 J/kg; if unsuccessful increase to 2 J/kg
- Give 2nd shock consider amiodarone OR procainamide before 3rd shock
- Amiodarone 5mg/kg over 20-60min
- Procainamide 15mg/kg over 30-60min
- Give 2nd shock consider amiodarone OR procainamide before 3rd shock
- Adenosine
- 0.1mg/kg; immediately flush with 5cc normal saline
Wide-Complex
- Adenosine for differentiating SVT from ventricular tachycardia
- Consider only if rhythm is regular and QRS monomorphic
- Synchronized cardioversion
- Give 0.5-1 J/kg; if unsuccessful increase to 2 J/kg
- Give 2nd shock consider amiodarone OR procainamide before 3rd shock
- Amiodarone 5mg/kg over 20-60min
- Procainamide 15mg/kg over 30-60min
See Also
References
AHA 2010 Guidelines for PALS