Adult Tachycardia 2021

Question 1

Life threatening features of Tachycardia

Answer 1

Shock
Syncope
MI
Severe HF

Question 2

Management of tachy + life threatening features present

Answer 2

1. Synchronised DC shock up to 3 attempts
2. Amiodarone 300mg IV (10 - 20mins)
3. Repeat shock
4. Amiodarone 900mg Infusion / 24H

Question 3

Irregular Tachycardia, stable, broad QRS complex

Answer 3

AF with BBB
Torsades de Pointes (Polymorphic VT)

Question 4

Management of Torsades de Pointes
(Polymorphic VT)

Answer 4

Magnesium 2g (over 10mins)

Question 5

Management of AF with BBB

Answer 5

Treat as irregular narrow QRS complex tachy

Question 6

Regular Tachycardia, stable, broad QRS complex

Answer 6

VT
If Uncertain Rhythm = VT
Consider previous SVT with BBB / aberrant conduction

Question 7

Management of VT or uncertain rhythm

Answer 7

1. Amiodarone 300mg IV (over 10 - 60mins)
2. Synchronised DC shock up to 3 attempts

Question 8

Management of Tachycardia, stable, broad QRS complex but you are certain of previous SVT with BBB / aberrant conduction diagnosis

Answer 8

Treat as regular narrow QRS complex tachy

Question 9

Narrow QRS complex

Answer 9

<0.12s

Question 10

Broad QRS complex

Answer 10

> 0.2s

Question 11

If dealing with stable tachycardia then do what before starting treatment

Answer 11

Seek expert help

Question 12

Regular Tachycardia, stable, narrow QRS complex

Answer 12

SVT

Question 13

Irregular Tachycardia, stable, narrow QRS complex

Answer 13

AF

Question 14

Management of SVT

Answer 14

1. Adenosine 6mg rapid IV bolus
2. Adenosine 12mg rapid IV bolus
3. Adenosine 18mg rapid IV bolus
4. Verapamil / beta-blockers
5. Synchronised DC shock up to 3 attempts

Monitor ECG continuously

Question 15

Management of AF

Answer 15

1. Control rate: beta-blockers
2. Digoxin / Amiodarone if evidence of HF
3. Anti-coagulate if >48hours