Identify and treat underlying cause
• Maintain patent airway; assist breathing as necessary
• Oxygen (if hypoxemic)
• Cardiac monitor to identify rhythm; monitor blood pressure and oximetry
• IV access
• 12-lead ECG, if available
↓
Continuous 12 lead EKG recording.
Vagal Maneuver [e.g. Carotid Massage]
↓
Check BP
↓
Adenosine 6 mg IV
↓
Check BP
↓
Adenosine 12 mg IV
↓
Check BP
↓
Amiodarone 150mg IV or
Cardioversion
Consider expert consultation
↓
Check BP
—–
Cardiovert anytime if Persistent tachyarrhythmia causing:
• Hypotension?
• Signs of shock?
• Ischemic chest discomfort?
• Acute heart failure?
• Acutely altered mental status?
—–
Tip to remember: VA6A12A150Cv
V-Vagal Maneuver
A6-Adenosine 6mg
A12-Adenosine 12mg
A150-Amiodarone 150g IV over 10min
Cv-Cardioversion
