PALS: Tachycardia: Difference between revisions
| Line 20: | Line 20: | ||
==Wide-Complex== | ==Wide-Complex== | ||
*[[Adenosine]] for differentiating [[SVT]] from [[ | *[[Adenosine]] for differentiating [[SVT]] from [[ventricular tachycardia]] | ||
**Consider only if rhythm is regular and QRS monomorphic | **Consider only if rhythm is regular and QRS monomorphic | ||
*[[Synchronized cardioversion]] | *[[Synchronized cardioversion]] | ||
Revision as of 19:00, 15 November 2016
Background
- Algorithm assumes pulse and adequate perfusion
Narrow-Complex
Sinus tachycardia
- Treat underlying cause
Supraventricular
- Vagal stimulation (if will not delay medications/cardioversion)
- Infants/young children: apply ice to face
- Older children: Carotid sinus massage / 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
- Give 2nd shock consider amiodarone OR procainamide before 3rd shock
- Adenosine
- 0.1mg/kg; immediately flush with 5cc normal saline
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
References
AHA 2010 Guidelines for PALS