Tachycardia Flashcards
initial diagnosis of stable monomorphic wide complex
tachycardia
Adenosine
not be used if pattern is irregular
Adenosine
May be used to diagnose and treat wide complex tachycardia for SVT with
aberrant conduction
Adenosine
Stable monomorphic VTach
cardiovert. Start at 100J and increase stepwise
polymorphic VTach
unsynchronized shock
A-fib
biphasic dose A-fib 120 – 200 J
Initial dose for monophasic cardioversion is 200J
Atrial flutter and SVT
( 50-100j) either
monophasic or biphasic
A defibrillator mode
Cardioversion – synchronized
• Defibrillation - unsynchronized
Failure to push the SYNC button will result in
Be sure to push the SYNC button before your initial
dose and again before each subsequent dose.
• Failure to push the SYNC button will result in
defibrillation
• When the unit is in the sync mode a light will appear
over each R wave as shown
EXTERNAL PACING
External pacing is done using multifunction pads
• The anterior posterior position for pad location is
most effective
• Sedate the patient if conscious
• Set a heart rate of at least 60 beats per minute
• Adjust the current until both electrical and
mechanical capture is attained
• Mechanical cap occurs when a carotid pulse is felt
that matches the set rate
• Switch to trans -venous pacing ASAP
External pacing Contraindications
Asystole
– Pulseless VTach
External pacingSide effects
Skin burns
– Chest muscle contraction
– Chest discomfort
Rhythms that require early defibrillation
Ventricular fibrillation
– Pulseless ventricular tachycardia
– Multi form ventricular tachycardia (Torsades)
Adult Tachycardia with Pulse
Narrow Regular
Synchronized Cardioversion
50-100J
Adult Tachycardia with Pulse
Narrow Irregular
Synchronized Cardioversion
120-200J
