tachyarrythmia Flashcards
What has the 2015 Resuscitation Council (UK) guidelines simplified regarding tachycardia management?
Unified treatment algorithm for broad-complex tachycardia, narrow complex tachycardia, and atrial fibrillation
Previously, separate algorithms existed for each type of tachycardia.
What is the basic assessment conducted before classifying patients in tachycardia management?
ABC assessment
ABC stands for Airway, Breathing, Circulation.
What adverse signs indicate a patient is unstable in tachycardia management?
Presence of any of the following:
* Shock: hypotension (systolic blood pressure < 90 mmHg)
* Pallor
* Sweating
* Cold, clammy extremities
* Confusion or impaired consciousness
* Syncope
* Myocardial ischaemia
* Heart failure
These signs guide the urgency of treatment.
What should be done if any adverse signs are present in a tachycardia patient?
Synchronised DC shocks should be given
Up to 3 shocks can be administered before seeking expert help.
How is treatment determined following the initial assessment in tachycardia management?
Based on whether the QRS complex is narrow or broad and whether the rhythm is regular or irregular
This classification affects the treatment approach.
What is the treatment for regular broad-complex tachycardia?
Assume ventricular tachycardia, administer loading dose of amiodarone followed by 24-hour infusion
This approach is taken unless SVT with bundle branch block is previously confirmed.
What should be done for irregular broad-complex tachycardia?
Seek expert help; possibilities include:
* Atrial fibrillation with bundle branch block
* Atrial fibrillation with ventricular pre-excitation
* Torsade de pointes
Identifying the underlying cause is crucial.
What is the initial treatment for regular narrow-complex tachycardia?
Vagal manoeuvres followed by IV adenosine
If unsuccessful, consider atrial flutter diagnosis.
What should be considered if the regular narrow-complex tachycardia treatment is unsuccessful?
Consider a diagnosis of atrial flutter and control the rate with beta-blockers
This is a common next step in management.
What is the probable diagnosis for irregular narrow-complex tachycardia?
Probable atrial fibrillation
This requires different treatment considerations.
What treatment options are available for atrial fibrillation with onset < 48 hours?
Consider electrical or chemical cardioversion
Early intervention can be crucial in management.
What is usually the first-line treatment for rate control in irregular narrow-complex tachycardia?
Beta-blockers unless contraindicated
Other medications may be used based on patient-specific factors.
