Sandbox/nct fire

Determine if the patient has any unstable signs or symptoms Most commonly, patients with a narrow QRS complex tachycardia present with palpitations ❑ Tachycardia ❑ Hypotension ❑ Loss of consciousness ❑ Severe dyspnea

❑ Unstable patient

❑ Stable patient

If the rhythm isn't sinus: ❑ Urgent DC cardioversion

If the rhythm is sinus: ❑ Control the rate: ❑ IV metoprolol (2.5 to 5 mg over 2 minutes up to a maximum of 15 mg) ❑ Treat the underlying cause

Continue with the diagnostic approach

❑ Assess airway, breathing, and circulation (ABC) ❑ Administer oxygen if necessary