Page 107 - AACN Essentials of Critical-Care Nursing Pocket Handbook, Second Edition
P. 107
94
Advanced Cardiovascular Life Support (ACLS) Tachycardia Algorithm
Perform immediate synchronized cardioversion • Establish IV access and give sedation if patient is conscious; do not delay cardioversion • Consider expert consultation • If pulseless arrest develops, see pulseless arrest algorit
4 Unstable 12 Wide QRS*: Is rhythm regular? Expert consultation advised
• Assess and support ABCs as needed • Identify and treat reversible causes
Tachycardia with pulses • Monitor ECG (identify rhythm), blood pressure, oximetry Symptoms persist Is patient stable? Unstable signs include altered mental status, ongoing chest pain, hypotension, or other signs of shock Note: rate-relate
1 • Give oxygen 3 Irregular
2 Stable Narrow QRS*: Is rhythm regular? 11
• Establish IV access • Obtain 12-lead ECG (when available) or rhythm strip Is QRS narrow (<0.12 second)? Narrow 6 Regular
5
7
4.6
