Template:ACLS Narrow Regular Tachycardia
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Narrow Regular Tachycardia
- Sinus tachycardia
- Treat underlying cause
- SVT
- Vagal maneuvers (convert up to 25%)
- Adenosine 6mg rapid IV push if patient hemodynamically stable (unstable should proceed directly to electrical cardioversion)
- Can follow with repeat dose of 6 mg or 12mg if initially fails
- If adenosine fails, initiate rate control with calcium channel blocker or beta blocker or use synchronized cardioversion
- Diltiazem 15-20mg IV, followed by infusion of 5-15mg/hr
- Metoprolol 5mg IVP x 3 followed by 50mg PO
- Synchronized cardioversion (50-100J)
- Provide sedation prior to synchronized cardioversion if patient is hemodynamically stable