Narrow Complex Tachycardias

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

Initial vitals demonstrate T: 36.5, R: 24, P: 180, BP: 70/40, O₂: 100%. Patient is awake and talking. You ask for initial EKG which demonstrates the following:

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, P: 200, R: 16, O₂: 100%, BP: 100/60.

Rhythm strip demonstrates the following:

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