Wed3November0903PM 4

According to the advanced life support (ALS) algorithm for tachyarrhythmias which of the following is appropriate?

(Please select 1 option)

Slow intravenous bolus of adenosine 6 mg, then 12 mg and then 12 mg for narrow complex regular tachycardia with no adverse features after vagal manoeuvres have failed

Beta-blockers or diltiazem for narrow complex, irregular tachycardia with no unstable features Correct

Intravenous magnesium (1.2-2 g) for polymorphic ventricular tachycardia (for example, torsade de pointes)

Intravenous amiodarone (900 mg) over 10-20 minutes after three unsuccessful DC cardioversions for ventricular tachycardia with a pulse

Synchronised DC cardioversion for ventricular tachycardia without a pulse

Explanation

Irregular, narrow complex tachycardia is likely to be atrial fibrillation and the Resuscitation Council (UK) advanced life support (ALS) guidelines recommend beta blockers or diltiazem if there are no unstable features.

ALS recommends a rapid bolus of adenosine for regular, narrow complex tachycardia that does not respond to vagal manoeuvres.

Synchronised shocks are recommended only when a pulse is palpable.

The loading dose of amiodarone is 300 mg IV over 10-20 minutes when three direct current (DC) cardioversions fail to convert ventricular tachycardia with a pulse.

Severe asthma is treated with 1.2-2 g of intravenous magnesium, whereas torsade de pointes requires 2 g IV.

Reference:

Resuscitation Council (UK). Peri-arrest arrhythmias.

Answer Statistics

1

15%

2

20%

3

60%

4

3%

5

5%

Times answered: 330