Ventricular Tachycardia with a Palpable Pulse - Revision history

Mfrdmanager at 13:41, 13 November 2020

2020-11-13T13:41:21Z

Mfrdmanager: /* STABLE AND SYMPTOMATIC: */

2018-03-21T21:14:54Z

‎STABLE AND SYMPTOMATIC:

Mfrdmanager: Protected "Ventricular Tachycardia with a Palpable Pulse" ([Edit=Allow only administrators] (indefinite) [Move=Allow only administrators] (indefinite))

2018-02-10T14:06:59Z

Protected "Ventricular Tachycardia with a Palpable Pulse" ([Edit=Allow only administrators] (indefinite) [Move=Allow only administrators] (indefinite))

Mfrdmanager: Created page with "==Section 4 - CARDIAC== ===4.09 VENTRICULAR TACHYCARDIA with a PALPABLE PULSE=== * INITIAL MEDICAL CARE (2.01) - OXYGEN @ 100% via NRB..."

2018-02-10T14:06:53Z

Created page with "==Section 4 - CARDIAC== ===4.09 VENTRICULAR TACHYCARDIA with a PALPABLE PULSE=== * INITIAL MEDICAL CARE (2.01) - OXYGEN @ 100% via NRB..."

New page

==Section 4 - CARDIAC==
===4.09 VENTRICULAR TACHYCARDIA with a PALPABLE PULSE===

* [[Initial Medical Assessment and Care|INITIAL MEDICAL CARE (2.01)]] - OXYGEN @ 100% via NRB mask or assist with BVM.
====STABLE AND SYMPTOMATIC:====
* Administer [[Antiarrhythmics|AMIODARONE]] 150 mg in 50 ml over 10 minutes.
:'''OR'''
* [[Antiarrhythmics|LIDOCAINE]] 1.5 mg / kg IVP. If NO response, repeat at 0.5 mg / kg IVP in 5 minutes. If tachycardia converts start [[Antiarrhythmics|LIDOCAINE]] DRIP @ 2 mg / minute;
**If NO response, repeat [[Antiarrhythmics|LIDOCAINE]] 0.5 mg/kg IVP until maximum of 3 mg/kg administered.
* In patients over age 70 or in those with known hepatic disease, administer [[Antiarrhythmics|LIDOCAINE]] at a full loading dose or until maximum of 1.5 mg/kg administered.

'''''Physician's Orders: If NO response, contact Medical Control for consult.'''''

====UNSTABLE:====
{| class="wikitable"
|-
! Definition of Unstable: Persistent Wide Complex Tachyarrhythmia causing:
|-
|
*Hypotension or signs of decreased tissue perfusion
*Significant dyspnea or significant compromise of the airway
*Acute mental status change
*Signs/symptoms of shock
*Acute heart failure
*Ischemic chest discomfort
|}
* SYNCHRONIZED CARDIOVERSION
** Initial recommended doses:
*** If narrow and regular complexes 50-100 Joules biphasic
*** If narrow and irregular complexes 120-200 Joules biphasic
*** If wide and regular complexes 100 Joules biphasic
*** If wide and irregular complexes – use defibrillation dose (not synchronized)
* If IV established prior to patient becoming UNSTABLE, may administer VERSED 2-5 mg IVP, IO or IN AND REPEAT 2 mg every 30 seconds to one minute if patient is conscious.
* If Ventricular Tachycardia converts refer to STABLE PRACTICE PARAMETER for administration of [[Antiarrhythmics|LIDOCAINE]].
* If NO response, SYNCHRONIZED CARDIOVERSION @ 200 Joules.
* If NO response, SYNCHRONIZED CARDIOVERSION @ 360 Joules.

{| class="wikitable"
|-
! DEFIBRILLATION should be considered instead of synchronized cardioversion if the patient is deteriorating rapidly to avoid delays associated with synchronization.
|}

[[Category:Cardiac|0409]]

@@ Line 4: / Line 4: @@
 * [[Initial Medical Assessment and Care|INITIAL MEDICAL CARE (2.01)]] - OXYGEN @ 100% via NRB mask or assist with BVM.
 ====STABLE AND SYMPTOMATIC:====
+* Administer [[Amiodarone|AMIODARONE]] 150 mg in 50 ml over 10 minutes.
-* [[Antiarrhythmics|LIDOCAINE]] 1.5 mg / kg IVP. If NO response, repeat at 0.5 mg / kg IVP in 5 minutes. If tachycardia converts start [[Antiarrhythmics|LIDOCAINE]] DRIP @ 2 mg / minute;
+:'''OR'''
-**If NO response, repeat [[Antiarrhythmics|LIDOCAINE]] 0.5 mg/kg IVP until maximum of 3 mg/kg administered.
+* [[Lidocaine|LIDOCAINE]] 1.5 mg / kg IVP. If NO response, repeat at 0.5 mg / kg IVP in 5 minutes. If tachycardia converts start [[Lidocaine|LIDOCAINE]] DRIP @ 2 mg / minute;
-* In patients over age 70 or in those with known hepatic disease, administer [[Antiarrhythmics|LIDOCAINE]] at a full loading dose or until maximum of 1.5 mg/kg administered.
+**If NO response, repeat [[Lidocaine|LIDOCAINE]] 0.5 mg/kg IVP until maximum of 3 mg/kg administered.
 '''''Physician's Orders: If NO response, contact Medical Control for consult.'''''
@@ Line 31: / Line 32: @@
 *** If wide and irregular complexes – use defibrillation dose (not synchronized)
 * If IV established prior to patient becoming UNSTABLE, may administer VERSED 2-5 mg IVP, IO or IN AND REPEAT 2 mg every 30 seconds to one minute if patient is conscious.
-* If Ventricular Tachycardia converts refer to STABLE PRACTICE PARAMETER for administration of [[Antiarrhythmics|LIDOCAINE]].
+* If Ventricular Tachycardia converts refer to STABLE PRACTICE PARAMETER for administration of [[Lidocaine|LIDOCAINE]].
 * If NO response, SYNCHRONIZED CARDIOVERSION @ 200 Joules.
 * If NO response, SYNCHRONIZED CARDIOVERSION @ 360 Joules.

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