2015 Trumbull Memorial Hospital Demo

Narrow Complex Tachycardia Narrow Complex Tachycardia

Universal Patient Assessment

Consider screening for the underlying cause of the tachycardia.

SVT originating in the atria (A-fib/A-flutter) does not respond to Adenosine.

Oxygen Titrate SpO2 to 94%

Vagal Maneuvers: Valsalva

Adult Airway Protocol

Only base treatment on the palpable pulse rate, not the monitor’s rate!

Cardiac Monitor 12-Lead ECG If EMT or STEMI, transmit

Manufacturer’s Doses  Zoll – 75 J initial

 120, 150, 200, 200, 200  Physio – 50-100 J initial  150, 200, 200, 200, 200  Philips – 50-100 J initial  150, 200, 200, 200, 200

Appropriate Arrest Protocol

No

Palpable Pulse?

Adult IV/IO

Narrow Complex Tachycardia

Unstable

Stable

PSVT A-fib/A-flutter Heart Rate >150

PSVT Heat Rate >150

A-fib/A-flutter Heart Rate >150

Fluid Bolus 1000mLNormal Saline

Synchronized Cardioversion at Manufacturer’s Doses Consider ketamine 0.4mg/kg IM prior, but do not delay cardioversion

Vagal Maneuvers

Repeat x1 if lung sounds are clear.

Adenosine 6mg rapid IVP

Adenosine 12mg rapid IVP May repeat once if there was any change following first 12

If patient converts at any time with cardioversion, reassess, monitor, oxygenate, and transport.

14

EMR

EMT

AEMT

Paramedic

Extended