Template:ACLS Wide Irregular Tachycardia
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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