PALS: tachycardia: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "1 mg" to "1mg") |
Neil.m.young (talk | contribs) (Text replacement - "5 mg" to "5mg") |
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| Line 12: | Line 12: | ||
***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 | ||
**Adenosine | **Adenosine | ||
***0.1mg/kg; immediately flush with 5cc NS | ***0.1mg/kg; immediately flush with 5cc NS | ||
| Line 23: | Line 23: | ||
**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== | ||
Revision as of 04:25, 20 July 2016
Background
- Algorithm assumes pulse and adequate perfusion
Narrow-Complex
- Sinus tachycardia - treat underlying cause
- Supraventricular
- Vagal stimulation (if will not delay meds/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 NS
- Vagal stimulation (if will not delay meds/cardioversion)
Wide-Complex
- Adenosine for differentiating SVT from VT
- 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