AVNRT : atrioventricular non re-entry tachycardia

AVRT : atrioventricular re-entry tachycardia Tachycardia with pulse

AF : atrial fibrilation Cardioversi sync
AFL : atrial flutter
ATAC : atrial tachycardia
(rarely needed for HR 150
NPJT : non paroxysmal junctional tachycardia Unstable or
MAT : multivocal atrial tachycardia
VT : ventricular tachycardia
Defibrilation for PMVT
Unstable = hypotension, shock
WCT : wide complex tachycardia Chest pain, heart failure
WPW : wolf Parkinson white
PMVT : polymorphic ventricular tachycardia
Stable
IV access, O2, Monitor BP & rhythm, 12 lead ECG

Narrow complex QRS (<120 msec) Wide complex QRS (120 msec)

Regular Irregular Regular Irregular

Vagal maneuvers AF, AFL or MAT VT or WCT AF w/ abberancy

Control rate w/ diltiazem Try adenosine Control rate w/ diltiazem or metoprolol
Adenosine Or metoprolol
No respone then : AF + WPW
Converts Does not Procainamide or Amio, proc or ibutilide
converts Amiodarone or
Sotalol or PMVT (normal QT)
Likely AVNRT or AVRT
Lidocaine Treat ischemia, amio or lidocaine & prepare
Recurrence Adenosine
& prepare for sync cardioversion For defibrillation
Or Possibly AFL, ATAC, NPJT
long acting AV nodal Control rate w/ diltiazem or Torsades ( QT)
Agents (diltiazem or Metoprolol Correct electrolyte & other precip
metoprolol
Mg 2 g IV
Overdrive pacing or isopreterenol
 Bradycardia with pulse

Airway, IV access, O2, Monitor BP & rhythm, 12 lead ECG

Hypotension, shock, chest pain, Unstable No Observe

Heart failure

Yes
AVB Type II / Type III,
Proceed to pacing ASAP Atropine 0.5 mg IV 3 5 min, max 3 mg

Transvenous pacing or
Dopamine 2 10 mcg/kg/min, or
Epinephrine 2 10 mcg/min, or
Isoproterenol 2 10 mcg/min

Transvenous pacing