View source for PALS: tachycardia

''This page is for <u>pediatric</u> patients; for adult patients see [[ACLS: Tachycardia]]''
==Background==
*Algorithm assumes pulse and adequate perfusion

==[[narrow complex tachycardia|Narrow-Complex]]==
===[[Sinus tachycardia]]===
*Treat underlying cause

===[[SVT|Supraventricular]]===
*[[Vagal stimulation]] (if will not delay medications/cardioversion)
**Infants/young children: apply ice to face
**Older children: Carotid sinus massage / [[valsalva maneuver|Valsalva]]
*[[Synchronized cardioversion]]
**Use if unstable or [[adenosine]] ineffective
**Give 0.5-1 J/kg; if unsuccessful increase to 2 J/kg
***Give 2nd shock consider [[amiodarone]] OR [[procainamide]] before 3rd shock
****[[Amiodarone]]  5mg/kg over 20-60min
****[[Procainamide]] 15mg/kg over 30-60min
*[[Adenosine]]
**0.1mg/kg; immediately flush with 5cc normal saline

==[[wide complex tachycardia|Wide-Complex]]==
*[[Adenosine]] for differentiating [[SVT]] from [[ventricular tachycardia]]
**Consider only if rhythm is regular and QRS monomorphic
*[[Synchronized cardioversion]]
**Give 0.5-1 J/kg; if unsuccessful increase to 2 J/kg
**Give 2nd shock consider [[amiodarone]] OR [[procainamide]] before 3rd shock
***[[Amiodarone]]  5mg/kg over 20-60min
***[[Procainamide]] 15mg/kg over 30-60min

==See Also==
*[[PALS (Main)]]
*[[ACLS: Tachycardia]]
*[[SVT]]
*[[Critical care quick reference]]

==References==
<references/>
AHA 2010 Guidelines for PALS

[[Category:Critical Care]]
[[Category:Cardiology]]
[[Category:Pediatrics]]
[[Category:EMS]]