Tachycardia Narrow Complex Irregular

Scenario 1  Tachycardia -Palpitations

DX > 150 (<2 squares) QRS<.12

1 Concious

2 breathing oxygen

3 Pulse

4 BP >90

EKG

DX Narow Complex Irregular Tachycardia Stable

Rx Medication – Drug of choice Calcium channel blocker

Need to control rate control

Verapamil  Slow IV push5mg  over 5 minutes

Cardizam Diltiazam Drip 5-15mg/hr

or Cardizam (Diltiazem) .25mg per kg over 2-5 minutes

Scenario 2  Tachycardia -Distress

Tachy = > 150 (<2 squares) QRS<.12

1 Concious Obtunded Call a Code

2 Breathing oxygen

3 Pulse OK Tachy present

4 BP <90

EKG

DX Narrow Complex Afib with Rapid Ventricular Response – Unstable

RX Synchronised Cardioversion

Narrow Irregular 120-200 J