Template:ACLS Wide Irregular Tachycardia: Difference between revisions
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===[[Wide complex tachycardia|Wide ''Irregular'' Tachycardia]]=== | ===[[Wide complex tachycardia|Wide ''Irregular'' Tachycardia]]=== | ||
[[File:Torsades de Pointes (polymorphic VT).svg|thumb|Wide ''Irregular'' Tachycardia (consistent with [[Torsades De Pointes]]).]] | |||
:''DO NOT use AV nodal blockers as they can precipitate [[V-Fib]]'' | :''DO NOT use AV nodal blockers as they can precipitate [[V-Fib]]'' | ||
:''Pulseless: see [[Adult pulseless arrest]]'' | :''Pulseless: see [[Adult pulseless arrest]]'' | ||
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**[[Unsynchronized cardioversion]] (defibrillation) 200J | **[[Unsynchronized cardioversion]] (defibrillation) 200J | ||
*'''Stable''': | *'''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 | ||
Latest revision as of 16:52, 30 July 2025
Wide Irregular Tachycardia
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Wide Irregular Tachycardia (consistent with Torsades De Pointes).
- 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
- Unsynchronized cardioversion (defibrillation) 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