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EMR
EMT
AEMT
Paramedic
Extended
Wide Complex Tachycardia
Consider
Magnesium Sulfate
2g
IV/IO over 5-10 minutes if
Torsades de Pointes,
alcoholism, malnutrition
Consider
Lidocaine
1.5 mg/kg IV/IO
if allergic to Amiodarone
Repeat at 0.75 mg/kg
every 5 minutes
Max 3 mg/kg
Wide Complex Tachycardia
Universal Patient Assessment
Oxygen
Titrate SpO2 to 94%
Adult Airway Protocol
Cardiac Monitor
12-Lead ECG
If
EMT
or STEMI, transmit
Palpable Pulse?
Appropriate Arrest
Protocol
Synchronized Cardioversion
Use Manufacturer’s Recommended Doses
If V-Tach converts to viable rhythm
then converts back to V-Tach, perform
cardioversion at energy level
previously successful.
No
Yes
Unstable
Stable
Wide Complex Tachycardia
If recurrent VT
Amiodarone
150 mg over 5-
10 minutes IV/IO Drip or
VERY SLOW Push
Amiodarone
150 mg over 5-
10 minutes IV/IO Drip or
VERY SLOW Push
DO NOT use BOTH
Amiodarone AND
Lidocaine!
Manufacturer’s Doses
Zoll – 75 J initial
120, 150, 200, 200, 200
Physio – 100 J initial
150, 200, 200, 200, 200
Philips – 100 J initial
150, 200, 200, 200, 200