{"id":170,"date":"2018-10-22T15:41:14","date_gmt":"2018-10-22T15:41:14","guid":{"rendered":"https:\/\/www.proacls.com\/wiki\/?p=170"},"modified":"2018-12-12T22:05:28","modified_gmt":"2018-12-12T22:05:28","slug":"tachycardia","status":"publish","type":"post","link":"https:\/\/www.proacls.com\/wiki\/acls-algorithms\/tachycardia\/","title":{"rendered":"Tachycardia Algorithm"},"content":{"rendered":"\t\t\t<div \n\t\t\tclass=\"yotu-playlist yotuwp yotu-limit-min yotu-limit-max   yotu-thumb-169  yotu-template-grid\" 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>\n\t\t\t\t<div>\n\t\t\t\t\t\t\t\t\t\t<div class=\"yotu-wrapper-player\" style=\"width:600px\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"yotu-player\">\n\t\t\t\t\t\t\t<div class=\"yotu-video-placeholder\" id=\"yotu-player-6a0ec007eb1a7\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"yotu-playing-status\"><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"yotu-pagination yotu-hide yotu-pager_layout-default yotu-pagination-top\">\n<a href=\"#\" class=\"yotu-pagination-prev yotu-button-prs yotu-button-prs-1\" data-page=\"prev\">Prev<\/a>\n<span class=\"yotu-pagination-current\">1<\/span> <span>of<\/span> <span class=\"yotu-pagination-total\">1<\/span>\n<a href=\"#\" class=\"yotu-pagination-next yotu-button-prs yotu-button-prs-1\" data-page=\"next\">Next<\/a>\n<\/div>\n<div class=\"yotu-videos yotu-mode-grid yotu-preset yotu-preset-gplus yotu-column-6 yotu-player-mode-large\">\n\t<ul>\n\t\t\t\t\t<li class=\" yotu-first\">\n\t\t\t\t\t\t\t\t<a href=\"#uvnDpZUNOJI\" class=\"yotu-video\" data-videoid=\"uvnDpZUNOJI\" data-title=\"What is Tachycardia?\" title=\"What is Tachycardia?\">\n\t\t\t\t\t<div class=\"yotu-video-thumb-wrp\">\n\t\t\t\t\t\t<div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"yotu-video-thumb\" src=\"https:\/\/i.ytimg.com\/vi\/uvnDpZUNOJI\/sddefault.jpg\" alt=\"What is Tachycardia?\">\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"yotu-video-title\">What is Tachycardia?<\/h3>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"yotu-video-description\"><\/div>\n\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\n\t\t\t\t\t\t<li class=\" yotu-last\">\n\t\t\t\t\t\t\t\t<a href=\"#IrE9VmJ-3CY\" class=\"yotu-video\" data-videoid=\"IrE9VmJ-3CY\" data-title=\"Tachycardia Teaching (ACLS Algorithms)\" title=\"Tachycardia Teaching (ACLS Algorithms)\">\n\t\t\t\t\t<div class=\"yotu-video-thumb-wrp\">\n\t\t\t\t\t\t<div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"yotu-video-thumb\" src=\"https:\/\/i.ytimg.com\/vi\/IrE9VmJ-3CY\/sddefault.jpg\" alt=\"Tachycardia Teaching (ACLS Algorithms)\">\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"yotu-video-title\">Tachycardia Teaching (ACLS Algorithms)<\/h3>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"yotu-video-description\"><\/div>\n\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\n\t\t\t\t<\/ul>\n<\/div><div class=\"yotu-pagination yotu-hide yotu-pager_layout-default yotu-pagination-bottom\">\n<a href=\"#\" class=\"yotu-pagination-prev yotu-button-prs yotu-button-prs-1\" data-page=\"prev\">Prev<\/a>\n<span class=\"yotu-pagination-current\">1<\/span> <span>of<\/span> <span class=\"yotu-pagination-total\">1<\/span>\n<a href=\"#\" class=\"yotu-pagination-next yotu-button-prs yotu-button-prs-1\" data-page=\"next\">Next<\/a>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\n<p>&nbsp;<\/p>\n<h2>What is Tachycardia<\/h2>\n<p><span style=\"font-weight: 400;\">A heart rate in adults that is greater than 100 beats per minute is technically defined as tachycardia. Many things can cause tachycardia\u2014fever, shock, medications, stress, metabolic dysfunction, hypoxemia, etc.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Perfusion problems may develop when the heart beats too fast and the ventricles are not able to fully fill with blood. This is called the ejection fraction compromise, due to the lack of pre-load before the heart fully contracts. This can cause a decrease in cardiac output, poor perfusion, and hemodynamic instability. <\/span><\/p>\n<h2>Signs and Symptoms of Tachycardia<\/h2>\n<p><span style=\"font-weight: 400;\">T<\/span><span style=\"font-weight: 400;\">he patient&#8217;s signs and symptoms should be quickly assessed to see if the symptoms are a result of the tachycardia. <\/span><span style=\"font-weight: 400;\">\u00a0A patient with a heart rate of 100<\/span><span style=\"font-weight: 400;\"> to 150 bpm rarely has symptoms related to the tachycardia. Symptoms in this range are typically a result of another medical issue. But the higher the heart rate, the more likely tachycardia is the culprit of the patient\u2019s symptoms. A thorough primary and secondary survey will help to properly assess the patient\u2019s condition.<\/span><\/p>\n<h2>Tachycardia Treatment<\/h2>\n<p><span style=\"font-weight: 400;\">When there is a patient with tachycardia, the first step is to identify whether or not the patient is stable. A stable patient <\/span><span style=\"font-weight: 400;\">usually does not have any serious signs or symptoms from the increased heart rate<\/span><span style=\"font-weight: 400;\">.<\/span><span style=\"font-weight: 400;\"> In other words, there is no altered mental status, no chest pain, no <\/span><span style=\"font-weight: 400;\">hypotension, or any other signs of shock. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">For a stable patient, the ACLS team should:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Check patient vitals<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Monitor oxygen saturation<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Give <a href=\"https:\/\/www.proacls.com\/wiki\/acls-pharmacology\/oxygen\/\">oxygen<\/a> as needed <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Get an ECG or 12 lead<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Identify the heart rhythm <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Start an IV<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">If the patient is unstable,<\/span><span style=\"font-weight: 400;\"> synchronized cardioversion should be done immediately. \u00a0If time permits and the patient is conscious, sedation may be considered to help with the discomfort from the electrical therapy. But if tim<\/span><span style=\"font-weight: 400;\">e does not permit, one may need to defibrillate regardless of sedation. \u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If a patient does not have a pulse, the rhythm should be treated as if it were <a href=\"https:\/\/www.proacls.com\/wiki\/ekg-rhythms\/ventricular-fibrillation\/\">ventricular fibrillation<\/a>, following the <a href=\"https:\/\/www.proacls.com\/wiki\/acls-algorithms\/pulseless-arrest\/\">pulseless arrest algorithm<\/a>. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The first step to identifying a tachycardic heart rhythm is to determine if the QRS complex is wide or narrow. A wide QRS complex is .12 seconds or greater, and a narrow QRS is less than .12 seconds. <\/span><span style=\"font-weight: 400;\">Narrow complex tachycardias typically originate above the ventricles, while wide complex tachycardias typically originate in the ventricles and have a higher risk of deteriorating into cardiac arrest.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For a patient with a regular narrow-complex stable tachycardia, vagal maneuvers should be attempted first. If that does not work, <a href=\"https:\/\/www.proacls.com\/wiki\/acls-pharmacology\/adenosine\/\">adenosine<\/a> can be given at 6 mg rapid IV push. If the patient does not convert and remains stable, a second dose of <a href=\"https:\/\/www.proacls.com\/wiki\/acls-pharmacology\/adenosine\/\">adenosine<\/a> can be given at 12 mg rapid IV push. After receiving adenosine, patients may feel breathless or feel as if their heart is skipping a beat. This will pass quickly, and they will return to feeling normal.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For a stable patient with an ECG rhythm that shows an irregular narrow-complex QRS tachycardia, it is probably <a href=\"https:\/\/www.proacls.com\/wiki\/ekg-rhythms\/atrial-fibrillation\/\">atrial fibrillation<\/a>, <a href=\"https:\/\/www.proacls.com\/wiki\/ekg-rhythms\/atrial-flutter\/\">atrial flutter<\/a>, or multifocal atrial tachycardia. This would require expert consultation for treatment.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">An expert consultation is also required for a stable patient that has regular or irregular wide-complex QRS tachycardia. Often, antiarrhythmics, such as <a href=\"https:\/\/www.proacls.com\/wiki\/acls-pharmacology\/procainamide\/\">procainamide<\/a> or <a href=\"https:\/\/www.proacls.com\/wiki\/acls-pharmacology\/amiodarone\/\">amiodarone<\/a>, are used to treat this. However, the management and treatment of wide complex stable tachycardias requires advanced knowledge of ECG rhythm interpretation and antiarrhythmic therapy.<\/span><\/p>\n<h2>Adult Tachycardia with a Pulse Algorithm<\/h2>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-393\" src=\"https:\/\/www.proacls.com\/wiki\/wp-content\/uploads\/2018\/10\/tachycardia.jpg\" alt=\"Adult Tachycardia with a Pulse Algorithm\" width=\"1500\" height=\"1845\" \/><\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; What is Tachycardia A heart rate in adults that is greater than 100 beats per minute is technically defined as tachycardia. Many things can cause tachycardia\u2014fever, shock, medications, stress, metabolic dysfunction, hypoxemia, etc. Perfusion problems may develop when the heart beats too fast and the ventricles are not able to fully fill with blood. [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[8],"tags":[],"class_list":["post-170","post","type-post","status-publish","format-standard","hentry","category-acls-algorithms"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Tachycardia Algorithm - ACLS Wiki<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.proacls.com\/wiki\/acls-algorithms\/tachycardia\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Tachycardia Algorithm - ACLS Wiki\" \/>\n<meta property=\"og:description\" content=\"&nbsp; What is Tachycardia A heart rate in adults that is greater than 100 beats per minute is technically defined as tachycardia. Many things can cause tachycardia\u2014fever, shock, medications, stress, metabolic dysfunction, hypoxemia, etc. Perfusion problems may develop when the heart beats too fast and the ventricles are not able to fully fill with blood. 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Many things can cause tachycardia\u2014fever, shock, medications, stress, metabolic dysfunction, hypoxemia, etc. Perfusion problems may develop when the heart beats too fast and the ventricles are not able to fully fill with blood. 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