PALS: Tachycardia: Difference between revisions
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*Algorithm assumes pulse and adequate perfusion | *Algorithm assumes pulse and adequate perfusion | ||
==Narrow-Complex== | ==[[narrow complex tachycardia|Narrow-Complex]]== | ||
===Sinus tachycardia=== | ===[[Sinus tachycardia]]=== | ||
*Treat underlying cause | *Treat underlying cause | ||
===Supraventricular=== | ===[[SVT|Supraventricular]]=== | ||
*[[Vagal stimulation]] (if will not delay medications/cardioversion) | *[[Vagal stimulation]] (if will not delay medications/cardioversion) | ||
**Infants/young children: apply ice to face | **Infants/young children: apply ice to face | ||
**Older children: Carotid sinus massage / Valsalva | **Older children: Carotid sinus massage / [[valsalva maneuver|Valsalva]] | ||
*[[Synchronized cardioversion]] | *[[Synchronized cardioversion]] | ||
**Use if unstable or [[adenosine]] ineffective | **Use if unstable or [[adenosine]] ineffective | ||
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**0.1mg/kg; immediately flush with 5cc normal saline | **0.1mg/kg; immediately flush with 5cc normal saline | ||
==Wide-Complex== | ==[[wide complex tachycardia|Wide-Complex]]== | ||
*[[Adenosine]] for differentiating [[SVT]] from [[ventricular tachycardia]] | *[[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 | ||
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