2015 Trumbull Memorial Hospital Demo
Narrow Complex Tachycardia Narrow Complex Tachycardia
Universal Patient Assessment
Consider screening for the underlying cause of the tachycardia.
SVT originating in the atria (A-fib/A-flutter) does not respond to Adenosine.
Oxygen Titrate SpO2 to 94%
Vagal Maneuvers: Valsalva
Adult Airway Protocol
Only base treatment on the palpable pulse rate, not the monitor’s rate!
Cardiac Monitor 12-Lead ECG If EMT or STEMI, transmit
Manufacturer’s Doses Zoll – 75 J initial
120, 150, 200, 200, 200 Physio – 50-100 J initial 150, 200, 200, 200, 200 Philips – 50-100 J initial 150, 200, 200, 200, 200
Appropriate Arrest Protocol
No
Palpable Pulse?
Adult IV/IO
Narrow Complex Tachycardia
Unstable
Stable
PSVT A-fib/A-flutter Heart Rate >150
PSVT Heat Rate >150
A-fib/A-flutter Heart Rate >150
Fluid Bolus 1000mLNormal Saline
Synchronized Cardioversion at Manufacturer’s Doses Consider ketamine 0.4mg/kg IM prior, but do not delay cardioversion
Vagal Maneuvers
Repeat x1 if lung sounds are clear.
Adenosine 6mg rapid IVP
Adenosine 12mg rapid IVP May repeat once if there was any change following first 12
If patient converts at any time with cardioversion, reassess, monitor, oxygenate, and transport.
14
EMR
EMT
AEMT
Paramedic
Extended
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