Adult Tachycardia With a Pulse Algorithm
This flowchart depicts the Adult Tachycardia with a Pulse Algorithm. It consists of numbered boxes and hexagons linked together with arrows, as well as an inset table to the right.
It originates at the top with box number 1. This orange box instructs, “Assess appropriateness for clinical condition. Heart rate typically greater than or equal to 150 beats per minute if tachyarrhythmia.”
From here, an arrow points downward to box 2. This green box is titled, “Identify and treat underlying cause.” It contains three main points:
- Maintain patent airway; assist breathing as necessary.
- Oxygen (if hypoxemic).
- Cardiac monitor to identify rhythm; monitor blood pressure and oximetry.
- Consider sedation.
- If regular narrow complex, consider adenosine.
- I.V. access and 12-lead ECG if available.
- Consider adenosine only if regular and monomorphic.
- Consider antiarrythmic infusion.
- Consider expert consultation.
- I.V. access and 12-lead ECG if available.
- Vagal maneuvers.
- Adenosine (if regular).
- Beta-blocker or calcium channel blocker.
- Consider expert consultation.
- Narrow regular: 50 to 100 Joules.
- Narrow irregular: 120 to 200 Joules biphasic or 200 Joules monophasic.
- Wide regular: 100 joules.
- Wide irregular: defibrillation dose (not synchronized).