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Pediatric Tachycardia Management Algorithm

This document provides an algorithm for managing tachycardia. It outlines assessing the airway, breathing, circulation and attaching monitoring equipment. For stable narrow complex tachycardia, it recommends vagal maneuvers or adenosine. For unstable or wide complex tachycardia, it suggests amiodarone, cardioversion or magnesium depending on the rhythm. It provides pediatric dosage guidelines.

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Gideon Bahule
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187 views1 page

Pediatric Tachycardia Management Algorithm

This document provides an algorithm for managing tachycardia. It outlines assessing the airway, breathing, circulation and attaching monitoring equipment. For stable narrow complex tachycardia, it recommends vagal maneuvers or adenosine. For unstable or wide complex tachycardia, it suggests amiodarone, cardioversion or magnesium depending on the rhythm. It provides pediatric dosage guidelines.

Uploaded by

Gideon Bahule
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

TACHYCARDIA MANAGEMENT

ALGORITHM
AIRWAY
Open, maintain and protect as necessary
2015 2015

BREATHING
Administer oxygen if required. Target Saturation 94 - 98%
Ventilate if necessary

CIRCULATION
Assess pulse, blood pressure and
perfusion
Attach ECG monitor, pulse oximeter
and vital signs monitor if available

DRIP
Establish IV access

ECG RHYTHM
Run rhythm strip to confirm dysrhythmia SPECIALIST MEDICAL ADVICE
12 lead ECG if possible SHOULD BE SOUGHT
Identify and treat underlying causes WHENEVER POSSIBLE

SIGNS OF INSTABILITY
• Hypotension
• Acutely altered mental state
• Signs of shock
• Ischaemic chest discomfort
• Acute heart failure

TACHYCARDIA
HR > 150/min * See Paed Rates

STABLE UNSTABLE SYNCHRONISED


NARROW COMPLEX
TACHYCARDIA CARDIOVERSION
(Supraventricular Tachycardia) Consider procedural sedation
HR > 150/min with QRS < 0.12 sec
Start with 100J initially
WIDE COMPLEX (monophasic or biphasic)
VAGAL STIMULATION
TACHYCARDIA
(NOT if varying R-R intervals / Paediatric start 0.5 - 1J/kg
(Ventricular Tachycardia)
Atrial fibrillation) then 2J/kg (Max 4J/kg)
Generally HR > 150/min with
Preferable: Valsalva (Modified)
QRS > 0.12 sec
Alternatives
Ice water applied to face AMIODARONE
Coughing / Breath-holding 150 mg in 5% D/W over * Paediatric Tachycardia Rates
Carotid Sinus Massage (C/I if bruits, 10min IV (15 mg / min), QRS < 0.08sec
CVS disease, elderly) then 1 mg / min infusion
ADENOSINE Consider (if Torsades de Pointes): QRS > 0.08 sec
(NOT if varying R-R intervals / • Defibrillation (Asynchronous)
Atrial fibrillation) • Magnesium (2g IV over 10min) Paediatric Drug Doses
Adenosine 0.1mg / kg rapidly
6 mg IV rapidly, then 12mg IV • Correct Electrolytes and consider
followed by 0.2mg / kg
after 1 - 2min prn toxins/drugs
Alternatives Amiodarone 5mg / kg
over 20 - 60min (max 300mg)
(esp irregular rhythms)
• BB or CCB Magnesium 50 mg / kg

AMIODARONE
150 mg in 5% D/W over 10 minutes
IV (15 mg/min) then 1 mg/min infusion

Alternatives
(esp irregular rhythms)
• BB or CCB * BB = Beta Blockers
* CCB = Calcium Channel Blockers

www.resuscitationcouncil.co.za

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