Stable Tachycardias (Wide QRS > 0.12 sec)
Home

Algorithms

Rhythms

Schedule

Pretest
God Knows
God Knows
Primary Assessment
Identify and treat underlying cause:
  -Consider causes (Differential Diagnosis-see PEA for Hs and Ts for
   some possibilities and treatments)

Ask these questions, does the patient have:
            1. Hypotension? (decreased blood pressure SBP < 90
                mmHg)
            2. Altered mental status?
            3. Signs of shock?
            4. Ischemic chest discomfort?
            5. Acute heart failure?

If the answer is NO to all of the these:

Assess Rapid Heart Rate as Narrow or Wide Complex Tachycardia?

Yes - QRS complex > 0.12 - Wide

VT or VF

Is the rhythm regular or irregular?

If rhythm is irregular then treatment:

*Amiodarone 150 mg bolus over 10 min, then 1 mg/min for 6 hours, then
0.5 mg/min to maximum dose of 2.2 grams in 24 hours.

*Procainamide 20-50 mg/min, then hang a drip at 1-4 mg/min - Can
     prolong the QT interval - Do not give to patients with a prolonged QT
     interval.

*Sotalol 100 mg IV over 5 minutes - Can prolong the QT interval - Do
     NOT give to patients with a prolonged QT interval.