Pulseless ventricular tachycardia interventions: Difference between revisions

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VisualWikitext

Latest revision as of 00:38, 10 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]

Overview

Immediate defibrillation is the main intervention for pVT.

Defibrillation^[1]^[2]

As opposed to other unstable Ventricular tachycardia, PVT should be managed with immediate defibrillation. A high energy defibrillator (150-200 J on biphasic and 360 J on monophasic) should be used for the initial shock dose, followed by an equal or higher shock dose for successive shocks
5 CPR cycles each containing 30 chest compressions and 2 breaths should be done after the first shock is delivered. Each subsequent shock should be followed by airway management with Oxygen delivery, and IV access with vasopressors.

ACLS Cardiac Arrest Algorithm

Adult Cardiac Arrest

Start CPR
Give oxygen
Attach monitor/defibrillator

Rhythm shockable?

Yes

No

VF/pVT

Asystole/PEA

Shock

Box A:

CPR 2 min
IV/IO access

Rhythm shockable?

No

Yes

Shock

Box B:

CPR 2 min
Epinephrine every 3-5 min
Consider advanced airway
and capnography

Box C:

CPR 2 min
IV/IO access
Epinephrine every 3-5 min
Consider advanced airway
and capnography

Rhythm shockable?

No

Rhythm shockable?

Yes

No

Shock

CPR 2 min
Amiodarone or Lidocaine
Treat reversible causes

Box D:

CPR 2 min
Treat reversible causes

Go back to box A

No

Rhythm shockable?

Yes

Shock
Then, go to box A or box B

If no signs of return of spontaneous circulation:
Go to box C or box D

If return of spontaneous circulation:
Start post cardiac arrest care

Adapted from Adult Cardiac Arrest Algorithm - 2018 Update^[3]

References

↑ "What are the treatment options for pulseless ventricular tachycardia (VT)?".
↑ Foglesong A, Mathew D. PMID 32119354 Check |pmid= value (help). Missing or empty |title= (help)
↑ "www.ahajournals.org".

Template:WH Template:WS

[urlWhat_are_the_treatment_options_for_pulseless_ventricular_tachycardia_(VT)?-1] "What are the treatment options for pulseless ventricular tachycardia (VT)?".

[pmid32119354-2] Foglesong A, Mathew D. PMID 32119354 Check |pmid= value (help). Missing or empty |title= (help)

[urlwww.ahajournals.org-3] "www.ahajournals.org".

[1]

[2]

[3]

@@ Line 5: / Line 5: @@
 Immediate defibrillation is the main intervention for pVT.
+==Defibrillation<ref name="urlWhat are the treatment options for pulseless ventricular tachycardia (VT)?">{{cite web |url=https://www.medscape.com/answers/159075-67727/what-are-the-treatment-options-for-pulseless-ventricular-tachycardia-vt |title=What are the treatment options for pulseless ventricular tachycardia (VT)? |format= |work= |accessdate=}}</ref><ref name="pmid32119354">{{cite journal |vauthors=Foglesong A, Mathew D |title= |journal= |volume= |issue= |pages= |date= |pmid=32119354 |doi= |url=}}</ref>==
-==Defibrillation<ref name="urlWhat are the treatment options for pulseless ventricular tachycardia (VT)?">{{cite web |url=https://www.medscape.com/answers/159075-67727/what-are-the-treatment-options-for-pulseless-ventricular-tachycardia-vt |title=What are the treatment options for pulseless ventricular tachycardia (VT)? |format= |work= |accessdate=}}</ref><ref name="pmid32119354">{{cite journal |vauthors=Foglesong A, Mathew D |title= |journal= |volume= |issue= |pages= |date= |pmid=32119354 |doi= |url=}}</ref>==
+*As opposed to other unstable [[Ventricular tachycardia]], PVT should be managed with '''immediate [[defibrillation]]'''. A high energy defibrillator (150-200 J on biphasic and 360 J on monophasic) should be used for the initial shock dose, followed by an equal or higher shock dose for successive shocks
+*5 CPR cycles each containing 30 chest compressions and 2 breaths should be done after the first shock is delivered. Each subsequent shock should be followed by airway management with Oxygen delivery, and IV access with [[vasopressors]].
+===ACLS Cardiac Arrest Algorithm===
+{{familytree/start |summary=PE diagnosis Algorithm.}}
+{{familytree | | | | | | | | | | | | | A01 | | | | | A01='''Adult Cardiac Arrest'''}}
+{{familytree | | | | | | | | | | | | | |!| | | | | | | }}
+{{familytree | | | | | | | | | | | | | A02 | | | | | | A02='''Start [[CPR]]'''<br>Give oxygen<br>Attach monitor/defibrillator}}
+{{familytree | | | | | | | | | | | | | |!| | | | | | | }}
+{{familytree | | | | | | | | | | | | | A03 | | | | | | A03='''Rhythm shockable?'''}}
+{{familytree | | | | |,|-|-|-|-|-|-|-|-|^|-|-|-|-|-|-|-|.| | }}
+{{familytree | | | | B01 | | | | | | | | | | | | | | | B02 | B01=Yes| B02=No}}
+{{familytree | | | | |!| | | | | | | | | | | | | | | | |!| | }}
+{{familytree | | | | C01 | | | | | | | | | | | | | | | C02 | C01='''[[VF]]/[[pVT]]'''| C02='''[[Asystole]]/[[PEA]]'''}}
+{{familytree | | | | |!| | | | | | | | | | | | | | | | |!| | }}
+{{familytree | | | | D01 | | | | | | | | | | | | | | | |!| | D01=Shock}}
+{{familytree | | | | |!| | | | | | | | | | | | | | | | |!| | }}
+{{familytree | | | | E01 | | | | | | | | | | | | | | | |!| | E01=<u>'''''Box A:'''''</u><br><br>'''[[CPR]] 2 min'''<br>IV/IO access}}
+{{familytree | | | | |!| | | | | | | | | | | | | | | | |!| | }}
+{{familytree | | | | F01 |-| F02 |~|7| | | | | | | | | |!| | F01='''Rhythm shockable?'''| F02=No}}
+{{familytree | | | | |!| | | | | | |:| | | | | | | | | |!| | }}
+{{familytree | | | | G01 | | | | | |:| | | | | | | | | |!| | G01=Yes}}
+{{familytree | | | | |!| | | | | | |:| | | | | | | | | |!| | }}
+{{familytree | | | | H01 | | | | | |:| | | | | | | | | |!| | H01=Shock}}
+{{familytree | | | | |!| | | | | | |:| | | | | | | | | |!| | }}
+{{familytree | | | | I01 | | | | | |:| | | | | | | | | I02 | I01=<u>'''''Box B:'''''</u><br><br>'''[[CPR]] 2 min'''<br>[[Epinephrine]] every 3-5 min<br>Consider advanced airway<br>and [[capnography]]| I02=<u>'''''Box C:'''''</u><br><br>'''[[CPR]] 2 min'''<br> IV/IO access<br> [[Epinephrine]] every 3-5 min<br>Consider advanced airway<br>and [[capnography]]}}
+{{familytree | | | | |!| | | | | | |:| | | | | | | | | |!| | }}
+{{familytree | | | | J01 |-| J02 |~|C| | | | | | | | | J03 |-| J04 | J01='''Rhythm shockable?'''| J02=No| J03='''Rhythm shockable?'''| J04=Yes}}
+{{familytree | | | | |!| | | | | | |:| | | | | | | | | |!| | | |:| | }}
+{{familytree | | | | K01 | | | | | |:| | | | | | | | | K02 | | |:| | K01=Yes| K02=No}}
+{{familytree | | | | |!| | | | | | |:| | | | | | | | | |!| | | |:| | }}
+{{familytree | | | | L01 | | | | | |:| | | | | | | | | |!| | | |:| | L01=Shock}}
+{{familytree | | | | |!| | | | | | |:| | | | | | | | | |!| | | |:| | }}
+{{familytree | | | | M01 | | | | | |:| | | | | | | | | M02 | | |:| | M01='''[[CPR]] 2 min'''<br>[[Amiodarone]] or [[Lidocaine]]<br>Treat reversible causes| M02=<u>'''''Box D:'''''</u><br><br>'''[[CPR]] 2 min'''<br>Treat reversible causes}}
+{{familytree | | | | |!| | | | | | |:| | | | | | | | | |!| | | |:| | }}
+{{familytree | | | | N00 | | | | | |D|~|~|~|~| N01 |-| N02 | | |:| | N00= Go back to box A| N01=No| N02='''Rhythm shockable?'''}}
+{{familytree | | | | | | | | | | | |:| | | | | | | | | |!| | | |:| | }}
+{{familytree | | | | | | | | | | | |:| | | | | | | | | O01 | | |:| | O01=Yes}}
+{{familytree | | | | | | | | | | | |:| | | | | | | | | |!| | | |:| | }}
+{{familytree | | | | | | | | | | | |:| | | | | | | | | P01 |~|~|J| | P01=Shock <br> Then, go to box A or box B}}
+{{familytree | | | | | | | | | | | Q01 | | | | | | | | | | | Q01='''If no signs of return of spontaneous circulation:'''<br>Go to box C or box D<br><br>'''If return of spontaneous circulation:'''<br> Start post cardiac arrest care}}
+{{familytree/end}}
-*As opposed to other unstable Ventricular tachycardias, PVT should be managed with '''immediate defibrillation'''. A high energy defibrillator (150-200 J on biphasic and 360 J on monophasic) should be used for the initial shock dose, followed by an equal or higher shock dose for successive shocks
+'''Adapted from Adult Cardiac Arrest Algorithm - 2018 Update'''<ref name="urlwww.ahajournals.org">{{cite web |url=https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000613 |title=www.ahajournals.org |format= |work= |accessdate=}}</ref>
-*5 CPR cycles each containing 30 chest compressions and 2 breaths should be done after the first shock is delivered. Each subsequent shock should be followed by airway management with Oxygen delivery, and IV access with vasopressors.
 ==References==

Pulseless ventricular tachycardia interventions: Difference between revisions

Latest revision as of 00:38, 10 July 2020

Overview

Defibrillation[1][2]

ACLS Cardiac Arrest Algorithm

References

Navigation menu

Defibrillation^[1]^[2]