Peri-arrest rhythms Flashcards
Describe how you would manage a broad complex tachycardia.
determine if irregular or regular
if regular - assume VT
= IV amiodarone followed by 24 hour infusion
if irregular
- AF: <48hrs DC cardioversion or if > 48hrs then rate control + anticoagulation
- polymorphic VT (torsades de pointes)
= IV magnesium sulphate
describe how you would manage a narrow complex tachycardia.
determine if irregular or regular
if regular - assume SVNRT
- vagal manœuvres followed by adenosine
- if fails then assume atrial flutter and treat with beta blockers
if irregular
- AF: if < 48hrs then DC cardioversion but if > 48 hours treat with beta blockers and anticoagulation
when would give DC cardioversion in a patient with a tachycarrythmia?
if patients was unstable (showed one of the following signs);
- shock: systolic < 90, cold clammy skin, confusion
- syncope
- heart failure
- myocardial ischaemia
1st line management of bradycardia with haemodynamic compromise ?
IV atropine 500mcg
if bradycardia still persists after atropine, what are the other treatment options ?
IV atropine, up to 3mg can be given
transcutaneous pacing
isoprenaline/adrenaline infusion titrated to response
transvenous pacing (specialist advise required)
what are risk factors for systole in a patient with bradycardia ?
previous asystole
complete heart block with broad QRS complex
mobitz type II AV block
ventricular pause > 3 seconds