Tachycardia/Unstable
(Mental Status Changes, No Palpable Radial Pulse)
Narrow Complex
≤0.11 Sec
General Adult Assessment
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Cardiac monitor
Vascular Access
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Wide Complex
≥0.12 Sec
If IV established,
administer
ADENOSINE
12 mg rapid IVP
Rhythm change?
No
Synchonized
Cardioversion
Consider sedation:
ETOMIDATE
0.15 mg/kg IV
Torsades de Points
Monomorphic VT
Yes
Defibrillate
Consider sedation:
ETOMIDATE
0.15 mg/kg IV
Rhythm
change?
Synchonized
Cardioversion
Consider sedation:
ETOMIDATE
0.15 mg/kg IV
Rhythm
change?
No
MAGNESIUM
SULFATE
2.0 mg IV in 50 cc NS
over 10 min
Rhythm
change
No
Yes
No
AMIODARONE
150 mg in 50 cc NS
over 10 min
Rhythm
change
No
Rhythm change?
Yes
Yes
No
Repeat Synchonized
Cardioversion;
Assess need
for repeat sedation
Rhythm change?
Yes
Repeat
Defibrillation;
Assess need
for repeat sedation
Rhythm
change?
Yes
Repeat Synchonized
Cardioversion or
Defibrillate if VT not
resolved; Assess need
for repeat sedation
Rhythm
change?
No
No
Continue
General Adult
Assessment
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No
Transport
Transport
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General
Adult
Assessment
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Transport