Approach to the Patient with Regular Broad Complex Tachycardia - Flowchart
Approach to the Patient with Regular Broad Complex Tachycardia - Flowchart Approach to the Patient with Regular Broad Complex Tachycardia Approach to the Patient with Regular Broad Complex Tachycardia
Flowchart

See Chapter 39 for general approach to the patient with an arrhythmia

See Chapter 39 for general approach to the patient with an arrhythmia

See Chapter 39 for general approach to the patient with an arrhythmia

39

End

End

End

Regular broad complex tachycardia

Regular broad complex tachycardia

Regular broad complex tachycardia

Key observations (Table 1.1)
Oxygen, ECG monitor, IV access
Focused assessment (Table 39.1)

Key observations (Table 1.1)
Oxygen, ECG monitor, IV access
Focused assessment (Table 39.1)

Key observations (Table 1.1)
Oxygen, ECG monitor, IV access
Focused assessment (Table 39.1)

Table 1.1

Table 39.1

12-lead ECG and rhythm strip (Table 40.1)
Check electrolytes/creatinine

12-lead ECG and rhythm strip (Table 40.1)
Check electrolytes/creatinine

12-lead ECG and rhythm strip (Table 40.1)
Check electrolytes/creatinine

Table 40.1

Stabilize airway and breathing
Call resuscitation team
DC cardioversion
Refer to cardiologist

Stabilize airway and breathing
Call resuscitation team
DC cardioversion
Refer to cardiologist

Stabilize airway and breathing
Call resuscitation team
DC cardioversion
Refer to cardiologist




Patient unstable?

Patient unstable?

Patient unstable?

Yes

Yes

Yes

No

No

No

No action needed

No action needed

No action needed

ECG abnormality due to artifact (pseudoventricular tachycardia)? (Table 40.1, Fig 40.3)

ECG abnormality due to artifact (pseudoventricular tachycardia)? (Table 40.1, Fig 40.3)

ECG abnormality due to artifact (pseudoventricular tachycardia)? (Table 40.1, Fig 40.3)

Table 40.1 Fig 40.3

Yes

Yes

Yes

No

No

No

Treat as SVT (Chapter 42)

Treat as SVT (Chapter 42)

Treat as SVT (Chapter 42)

Chapter 42

ECG identical with previously condirmed supraventricular tachycardia (SVT) with bundle branch block? (Table 40.1)

ECG identical with previously condirmed supraventricular tachycardia (SVT) with bundle branch block? (Table 40.1)

ECG identical with previously condirmed supraventricular tachycardia (SVT) with bundle branch block? (Table 40.1)

Table 40.1

Yes

Yes

Yes

No

No

No

DC or chemical cardioversion (Table 41.3)
Refer to cardiologist

DC or chemical cardioversion (Table 41.3)
Refer to cardiologist

DC or chemical cardioversion (Table 41.3)
Refer to cardiologist

Table 41.3

Treat as ventricular tachycardia (Table 40.1, Fig. 40.2)
DC or chemical cardioversion (Table 40.2) or antitachycarida pacing
Refer to a cardiologist

Treat as ventricular tachycardia (Table 40.1, Fig. 40.2)
DC or chemical cardioversion (Table 40.2) or antitachycarida pacing
Refer to a cardiologist

Treat as ventricular tachycardia (Table 40.1, Fig. 40.2)
DC or chemical cardioversion (Table 40.2) or antitachycarida pacing
Refer to a cardiologist

Table 40.1 Fig. 40.2
Table 40.2

Could this be pre-excited atrial flutter or antidromic tachycardia? (Table 40.1)

Could this be pre-excited atrial flutter or antidromic tachycardia? (Table 40.1)

Could this be pre-excited atrial flutter or antidromic tachycardia? (Table 40.1)

Table 40.1

Yes

Yes

Yes

No

No

No