Adult Tachycardia With Pulse Management Algorithm
Adult Tachycardia with Pulse Algorithm
Figure 39
DOSES/DETAILS
Synchronized Cardioversion:
- Narrow regular: 50 to 100J
- Narrow irregular: Biphasic 120J to 200J Monophasic 200J
- Wide regular: 100J
- Wide irregular: defibrillation dose (NOT synchronized)
Adenosine IV Dose:
- Initial dose of 6 mg rapid IV push; follow with NS flush.
- Follow with second dose of 12 mg if required.
Antiarrhythmic Infusions for stable wide QRS tachycardia:
Procainamide IV Dose:
- 20 to 50 mg per minute until arrhythmia suppressed, hypotension ensues, or QRS duration increases >50%, maximum dose 17 mg/kg given.
- Maintenance infusion: 1 to 4 mg per minute. Avoid if prolonged QT or CHF
Amiodarone IV Dose:
- Initial dose: 150 mg over 10 minutes. Repeat as needed if VT recurs.
- Maintenance infusion: 1 mg per minute for first six hours
Sotalol IV Dose:
- 100 mg (1.5 mg/kg) over five minutes. Avoid if prolonged QT