Ventricular Tachycardia

A 12-year-old patient collapses at a sporting event.

Bystanders performed CPR on the scene. Patient arrives in the emergency department with initial vitals demonstrating T: 35, P: thread, BP: 60/30, O₂: 95%.
1. What are initial steps in management?*
- ABC’s
- Consult cardiology
- Cardiovert
- Adenosine

Staff is able to effectively manually bag the patient.

An IV is being established. Initial EKG demonstrates the following:
2. What is the initial treatment?*
- Amiodarone
- Defibrillation
- Cardioversion
- All of the above

As you are supporting airway, establishing IV access, giving IV fluids, and preparing for cardioversion, the nurse asks how many Joules you would like to use for cardioversion for this 40kg patient.
3. The answer is:*
- 20J via synchronized cardioversion
- 100J via synchronized cardioversion
- 20J via unsynchronized defibrillation
- 80J via synchronized cardioversion

You attempt cardioversion but unfortunately the patient remains unresponsive and now has lost a pulse.

Rhythm strip is unchanged:
4. What is the next step in management?*
- Cardioversion
- Defibrillation
- Amiodarone
- Administration of epinephrine

The patient remains in the same rhythm. You continue CPR.
5. Which of the following correctly describes the appropriate medication and dosing to be administered in pulseless ventricular tachycardia?*
- 1mg atropine, consider epinephrine during subsequent round of CPR
- 1mg epinephrine, consider 300mg amiodarone during subsequent round of CPR
- 1mg epinephrine, consider 150mg amiodarone during subsequent round of CPR
- 6mg adenosine, consider 150mg amiodarone during subsequent round of CPR