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ACLS Tachycardia Treatment Guide

The ACLS Tachycardia Algorithm is designed for patients with tachycardia over 150 beats per minute and a palpable pulse, emphasizing the importance of assessing cardiovascular stability. Unstable patients should receive synchronized cardioversion, while stable patients can be treated with vagal maneuvers and medications like adenosine. For wide QRS complex tachycardia, expert consultation and specific medications such as procainamide or amiodarone may be necessary.

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5 views3 pages

ACLS Tachycardia Treatment Guide

The ACLS Tachycardia Algorithm is designed for patients with tachycardia over 150 beats per minute and a palpable pulse, emphasizing the importance of assessing cardiovascular stability. Unstable patients should receive synchronized cardioversion, while stable patients can be treated with vagal maneuvers and medications like adenosine. For wide QRS complex tachycardia, expert consultation and specific medications such as procainamide or amiodarone may be necessary.

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We take content rights seriously. If you suspect this is your content, claim it here.
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ACLS Tachycardia Algorithm

[Link] 1/13/20, 11:05 AM


Page 1 of 3
1/13/2020
The ACLS Tachycardia Algorithm is used for patients who have marked tachycardia,
usually greater than 150 beats per minute, and a palpable pulse.

Some patients may have cardiovascular instability with tachycardia at heart rate less
than 150 bpm. It is important to consider the clinical context when treating adult
tachycardia.

If a pulse cannot be felt after palpating for up to 10 seconds, move immediately to the
ACLS Cardiac Arrest VTach and VFib Algorithm to provide treatment for pulseless ven-
tricular tachycardia.

The immediate response to an adult patient with tachycardia and a palpable pulse is:

To maintain an open airway


Assist breathing if necessary
Apply monitors to assess cardiac rhythm, blood pressure, blood oxygenation
Provide supplement oxygen to maintain O2 saturation between 94% and 99%

The main assessment in adult patients with tachycardia is to determine whether the
patient is stable or not. Signs of cardiovascular instability are hypotension, signs of
shock or acute heart failure (!ash pulmonary edema, jugular venous distention), al-
tered mental status, or ischemic chest pain.

Unstable patients with tachycardia should be treated with synchronized cardioversion


as soon as possible.

Cardioversion Rules

QRS narrow and regular 50-100 Joules

QRS narrow and irregular 120-200 Joules

QRS wide and regular 100 Joules

QRS wide and irregular Turn o" the synchronized mode and de#brillate

immediately

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Stable patients with tachycardia with a palpable pulse can be treated with more con-
servative measures #rst.

Attempt vagal maneuvers


If unsuccessful, administer adenosine 6 mg IV bolus followed by a rapid normal
saline !ush
If unsuccessful, administer adenosine 12 mg IV bolus followed by a rapid normal
saline !ush
Beta-blockers and calcium channel blockers may be considered for narrow QRS
tachycardia (QRS <0.12 sec)

For stable, wide QRS complex tachycardia (QRS ≥0.12 sec)


Strongly consider expert consultation
Consider procainamide 20-50 mg/min IV, OR
Amiodarone 150 mg IV over 10 minutes, OR
Sotalol 100 mg (1.5 mg/kg) over 5 minutes

[Link] 1/13/20, 11:05 AM


Page 3 of 3

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