PALS Megacode 7: Narrow Complex Tachycardias

You are treating an 11-year-old with light-headedness.

Initial vitals demonstrate T: 36.5 °C, RR: 24 breaths/min, HR: 180 bpm, BP: 70/40 mmHg, O₂: 100%. Patient is awake and talking. You ask for initial EKG which demonstrates the following:

1.What is the next step in management?

Amiodarone Defibrillate Cardioversion Lidocaine

You successfully cardiovert the patient.

Repeated EKG demonstrates normal sinus rhythm. The nurse calls you back into the room because the patient reports feeling light-headed with palpitations. Patient is awake and talking. Repeat vitals demonstrate the following, T: 36.5 °C, HR: 200 bpm, RR: 16 breaths/min, O₂: 100%, BP: 100/60 mmHg.

Rhythm strip demonstrates the following:

2.What is the appropriate medication and dosing for treatment?

Adenosine - 0.1 mg/kg Epinephrine - 0.01 mg/kg Lidocaine - 1.5 mg/kg Amiodarone - 5 mg/kg

The patient’s symptoms and rhythm strip are unchanged after initial dosage of Adenosine.

3.What is the next step in management?

IVFs Cardiovert Intubate Vagal maneuvers and Adenosine - 0.2 mg/kg

PALS Megacode 7: Narrow Complex Tachycardias

Hurry, don't let time run out!

Turn this success into CME Credit

Don’t stop here - Turn this into a learning opportunity

You are treating an 11-year-old with light-headedness.

You successfully cardiovert the patient.

The patient’s symptoms and rhythm strip are unchanged after initial dosage of Adenosine.

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PALS Megacode 7: Narrow Complex Tachycardias

Hurry, don't let time run out!

Turn this success into CME Credit

Don’t stop here - Turn this into a learning opportunity

PALS Megacodes

You are treating an 11-year-old with light-headedness.

You successfully cardiovert the patient.

The patient’s symptoms and rhythm strip are unchanged after initial dosage of Adenosine.

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