ACLS Megacode 8 Out-of-Hospital

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Step 1 of 9

You are a healthcare provider working in a rehabilitation center with ALS capabilities. A 66-year-old female 11 days post-op from a total hip arthroplasty complains of general malaise and heavy palpitations. The patient does not report any pain or difficulty breathing. A rapid initial assessment reveals the following:

Vital signs
  • Pulse rate: 161/min
  • Blood pressure: 120/80
  • Respiratory rate: 18/min
  • Temperature: 37.4 °C
Physiological systems
  • Integumentary: Pale, dry
  • Cardiovascular: Palpable peripheral pulses bilaterally
  • Respiratory: Lungs CTA bilaterally
  • Neurological: Alert, oriented
1. A cardiac monitor is attached to the patient. A rhythm check reveals sinus tachycardia at 161/min. The patient soon experiences a short run of ventricular tachycardia that converts spontaneously back to sinus tachycardia. During this run, you observe that the patient held their chest and appeared to have difficulty breathing, which has since subsided. What are your initial actions?*