Arrythmia management
Tachyarrythmias
Causes to consider
- Pain
- Hypoxia / lung collapse
- Pericardial collection
- Pneumothorax
- Pyrexia
- Electrolyte imbalance
- Hypoxia
- Lung collapse / atelectasis
- pneumothorax
- Pulmonary embolus
- Hypovolaemia
- Bleeding
- Inadequate filling
- Hyper/hypokalaemia
- Hypothermia
- Tension pneumothorax
- Tamponade
- Pericardial collection
- Toxic
- Thromboembolic phenomena
- Pulmonary embolus
- Support ABC
- Monitor ECG, BP, saturations
- Record 12 lead ECG
- Identify reversible causes
- Correct electrolyte imbalance - give:
- Potassium chloride 10-20mmol in 50mls 5% Dextrose iv / 20 minutes (via central line)
- Magnesium sulphate 20mmol in 50mls 5% Dextrose iv / 2g over 10 minutes
- Is the patient stable?
Unstable patient
- BP<90
- Reduced conscious level
- Chest pain
- "Failure"
- Synchronised DC shock: 150J biphasic, 200J monophasic (sedate as necessary)
- Amiodarone 300mg iv/1 + 900mgiv/24
| Broad Complex tachycardia | Narrow complex tachycardia | ||
| Regular / Ventricular tachycardia | Irregular / AF + BBB, Torsades | Regular / Atrial flutter | Irregular / Atrial fibrillation |
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Bradyarrythmias
- Ventricular pacing
- Atropine 1mg iv
- Glucagon (if B-blocker toxicity)
