Tachy w/ Pulse

Question 1

Regular tachy w/ narrow QRS and hemodynamically stable without confusion, chest pain or heart failure. Tx?

Answer 1

Vagal maneuvers
Adenosine
BBlocker or CCB
Consult

Question 2

Tachy w/ hemodynamic instability, confusion, shock, chest pain or heart failure. Tx?

Answer 2

Synchronized cardioversion

Adenosine if narrow complex.

Question 3

Regular tachy w/ wide QRS and hemodynamically stable without confusion, chest pain or heart failure. Tx?

Answer 3

Adenosine if regular & monomorphic
Antiarrhythmic infusion
Expert consultation

Question 4

Synchronized cardioversion dose for narrow, regular tachy

Answer 4

50-100 J

Question 5

Synchronized cardioversion dose for narrow, irregular tachy

Answer 5

120-200 J biphasic

200 J if monomorphic

Question 6

Synchronized cardioversion dose for wide, regular tachy

Answer 6

100 J

Question 7

Synchronized cardioversion dose for wide, irregular tachy

Answer 7

Defibrillation dose

Question 8

Adenosine dose

Answer 8

1st: 6 mg rapid IV push
2nd: 12 mg

Question 9

Procainamide IV

Answer 9

20-50 mg/min until arrhythmia suppressed, hypotension comes, QRS duration increases >50%, or max dose of 17 mg/kg given.

Question 10

Procainamide maintenance infusion

Answer 10

1-4 mg/min

Avoid if QT prolonged or CHF

Question 11

Amiodarone IV dose

Answer 11

1st: 150 mg over 10 min

Repeat if VT comes

Question 12

Amiodarone maintenance infusion

Answer 12

1 mg/min for 6 hrs

Question 13

Sotalol IV dose

Answer 13

100 mg (1.5 mg/kg) over 5 min