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Adult Tachycardia With Pulse Algorithm

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adult tachycardia with pulse algorithm


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/min until arrhythmia suppressed, hypotension ensues, or QRS duration increases >50%, maximum dose 17 mg/kg given.
Maintenance infusion: 1 to 4 mg/min 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/min for first 6 hours

Sotalol IV Dose:

100 mg (1.5 mg/kg) over 5 minutes. Avoid if prolonged QT

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