Adult Tachycardia

Question 0

Adult Tachycardia - Initial
-ECG
IV Ns at _________ rate titrate to SBP __________
Monitor pulse ox, with advanced airway adjunct as needed

Answer 0

TKO

90-100

Question 1

Adult Tachycardia - Criteria to make this protocol

Answer 1

Narrow QRS HR >150

Wide QRS HR >120

Question 2

Adult Tachycardia - Unstable Criteria

Answer 2

SBP <90 AND
Hypoperfusion, decreased sensorium, diaphoresis, chest pain, capillary refill greater than 2 seconds, cool extremities, or cyanosis.

Question 3

Adult Tachycardia - Not Unstable 1st step

Answer 3

12 lead to determine wide or narrow

Question 4

Adult Tachycardia - Not unstable post 12 lead- Wide QRS now what

Answer 4

Transport

Question 5

Adult Tachycardia - Post 12 lead - Narrow QRS - Now what do we need to know _____

Answer 5

Irregular or regular

Question 6

Adult Tachycardia - Post 12 lead - Narrow QRS - Irregular Afib or A flutter or MAT

Answer 6

Transport

Question 7

Adult Tachycardia - Post 12 lead - Narrow QRS- Regular……What now

Answer 7

perform Valsalva
Adenosine 6mg rapid IVP followed by 20ml NS

no response after 2 min

Adenosine 12 mg IVP followed by 20ml NS rapid IV flush.

Question 8

Adult Tachycardia Unstable - Versed Doses

Answer 8

IV/IO 1-6mg slow IVP. Titrate to pt comfort ….or

IM/IN 2mg dose, may repeat X2 @ 5min

Question 9

Adult Tachycardia Unstable - Synchronized cardioversion

• Energy
• Repeat

Answer 9

100,200,360

Check rhythm after each shock

Question 10

Adult Tachycardia Unstable -Post cardioversion

-What do you check

Answer 10

Rhythm wide or narrow

Question 11

Adult Tachycardia Unstable -post cardioversion- Wide - now what do you have to decide _____

Answer 11

Stable or unstable

Question 12

Adult Tachycardia Unstable -post cardioversion - Wide - Unstable

Answer 12

Amiodarone 150mg IVP/IO
Synchronized cardioverison
-max energy dose

Question 13

Adult Tachycardia Unstable -post cardioversion - wide QRS - stable
Now what _____

Answer 13

Amiodarone 150mg IV/IO over 10 min

Question 14

Adult Tachycardia Unstable -post cardioversion - Narrow- Now what

Answer 14

stable or unstable

Question 15

Adult Tachycardia Unstable -post cardioversion - narrow - unstable
what do you do ____

Answer 15

Synchronized cardioversion

-max energy dose.

Question 16

Adult Tachycardia Unstable -post cardioversion - narrow QRS- Stable Now what

Answer 16

Transport

Question 17

Adult Tachycardia - If unstable tachycardia returns after transiently converting (rather than persists without ever converting) _________________

Answer 17

Repeat energy level that was previously successful for cardioverison.

Question 18

6 H’s

Answer 18

Hypovolemia 
hypoxia 
hydrogen ion 
hypokalemia 
hypoglycemia 
hypothermia

Question 19

6 T’s

Answer 19

Tamponade
thrombosis
Tension pneumothorax 
trauma  
toxins