PALS: Tachycardia: Difference between revisions
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*****Procainamide 15 mg/kg over 30-60min | *****Procainamide 15 mg/kg over 30-60min | ||
**Adenosine | **Adenosine | ||
***0.1 mg/kg; immediately flush | ***0.1 mg/kg; immediately flush with 5cc NS | ||
==Wide-Complex== | ==Wide-Complex== | ||
Revision as of 23:06, 11 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 5 mg/kg over 20-60min
- Procainamide 15 mg/kg over 30-60min
- Give 2nd shock consider amiodarone OR procainamide before 3rd shock
- Adenosine
- 0.1 mg/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 5 mg/kg over 20-60min
- Procainamide 15 mg/kg over 30-60min
See Also
References
AHA 2010 Guidelines for PALS