MyCpdZw - Protocols Details

VENTRICULAR TACHYCARDIA

Ventricular tachycardia is a heart rhythm disorder (arrhythmia) caused by abnormal electrical signals in the lower chambers of the heart (ventricles)

Diagnosis

Wide compex tachycardia is ventricular tachycardia 90% of the time.

Most common in first ½ hour post acute myocardial infraction.

Management

1. High dose Oxygen,

2. Establish haemodynamic status, baseline observations,

3. Haemodynamic instability (Systolic blood pressure< 90, Heart rate >150 bpm, chest pain or heart failure)

· Sedate,

· Synchronized DC(direct current) shock 90J up to three times,

· Start Amiodarone infusion 300mg over 20-30 mins

· If refractory consider use of Procainamide, Flecanide or Bretyllium.

4. Haemodynamically stable:

· Lignocaine 50 mg IV over 2 minutes,

· Start Amiodarone infusion 300mg over 20-30 mins

· Check electrolytes- especially Magnesium

· If still refractory consider use of Amiodarone 300 mg IV 10 minutes followed by infusion of 600 mg over next hour or Procainamide,

· Consider DC shock if refractory.

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