ACLS Tachycardia with a pulse algorithm Flashcards

1
Q

What is the first step in this algorithm?

A

Airway, oxygen, cardiac monitor, vital signs

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2
Q

What is the second step of this algorithm?

A

Assess for hypotension, AMS, shock, Ischemic chest pain, acute heart failure

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3
Q

Patient is tachycardic with signs of AMS or shock, what is next?

A

Synchronized cardioversion

May consider adenosine if narrow complex and regular

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4
Q

Who immediately gets cardioverted?

A

Any tachycardia with hypotension, ischemic chest pain, AMS, shock, acute heart failure

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5
Q

What is the third step in this algorithm?

A

Assess if wide or narrow complex

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6
Q

Pt has tachycardia and without immediate complications and is found to have a wide complex, what is next?

A

EKG
Consider adenosisne if regular and monomorphic
Consider antiarrhythmic infusion
Consult specialist

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7
Q

What are the antiarrhythmic drugs used for wide complex and the initial doses?

A

Procainamide 20–50mg.min until resolution or hypotension or QRS duration increases more than 50% or max dose of 17mg/kg. Avoid in long QT or CHF

Amiodarone: 150mg over 10 minutes and repeat as needed

Sotalol: 1.5mg/kg over 5 minutes. Avoid in long QT

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8
Q

What is the intervention if no immediate complications and found to have a narrow complex?

A
EKG
Vagal maneuvers
Adenosine (if regular)
Beta blocker or calcium channel blocker
Expert consultation
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9
Q

What is the dosing of adenosine?

A

6mg fast IV push followed by NS push

12mg fast if needed for second dose

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10
Q

What is the dosing for cardioversion?

A

For narrow or wide and regular: 100 J synchronized
For narrow and irregular: 120–200 J synchronized
Wide irregular: defibrillate

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