Adult Wide Complex Tachycardia

Question 1

Stable patient wide complex VT or SVT with aberrancy.

Answer 1

Adenosine: 6mg IV/IO rapid push, then 12mg IV/IO x2
Amiodarone: 150mg in 100mL of D5W IV/IO over 10 minutes
450mg in 250mL of D5W at 1mg/min (33mL/hr)

Question 2

Unstable patient with a heart rate >150 and regular wide complex.

Answer 2

Sedation-Versed: 2-2.5mg IV/IO, repeat up to 5mg.

Sync Cardioversion: 100 joules

Question 3

Unstable patient with heart rate >150 and a irregular wide complex.

Answer 3

Sedation-Versed: 2-2.5mg IV/IO, repeat up to 5mg.
Sync Cardioversion: 200 joules
If Torsade de pointes converts administer Magnesium Sulfate 2gm IV/IO over 2 minutes