WITH SOLUTIONS GRADED A+
✔✔SVT-Supraventricular Tachycardia - ✔✔Action: Vagal Maneuvers, O2, notify MD -
Call RRT if symptomatic
First Drug: Adenosine (6mg, 12mg, 12mg - Rapid IV push)
Possible causes: stimulants, CHF, thyroid, med toxicity
(Could be Sinus Tach; Atrial Tach; Atrial Flutter; or Junctional Tach - cannot determine!)
✔✔1st Degree AV Block - ✔✔Action: observe for further PR prolongation; meds; if new
notify MD First Drug: None
Possible causes: heart disease or meds
✔✔2nd Degree AV Block Wenckebach-Type I - ✔✔Action: meds; O2 if dyspneic; If new
notify MD
First Drug: Atropine if symptomatic -BP
Possible causes: AV blocking meds, acute MI, edema post open-heart surgery
✔✔2nd Degree AV Block Type II - ✔✔Action: Notify MD; O2: set-up for temp pacer -
Call RRT if symptomatic
First Drug: If symptomatic - BP - ACLS recommends Atropine (caution with Dopamine
drip for BP
Possible causes: AV blocking meds, acute MI, edema post open-heart surgery
MI); may use
✔✔3rd Degree AV Block - ✔✔Action: Notify MD; O2: set-up for temp pacer (TCP) - If
symptomatic call RRT
First Drug: If symptomatic -BP - ACLS recommends TCP. Atropine can be administered
but should be given cautiously, because it is likely to be ineffective in a wide complex
QRS rhythm and can be dangerous if the patient is having a concurrent MI.
May consider Dopamine drip for BP
Possible causes: AV blocking meds, acute MI, edema post open-heart surgery
✔✔Premature Ventricular Contraction - PVC's - ✔✔(always note if they are unifocal or
multifocal Action: If new, frequent or multifocal notify MD, O2, standing orders for
treatment - determine the cause
First Drug: Amiodarone, Lidocaine, K+, Mg++
Possible causes:K or Mg, hypoxia, ischemia, MI, med toxicity
✔✔Ventricular Tachycardia - VT - ✔✔Action: With a pulse: Call RRT (unless
ICU/PACU), O2, prepare for synchronized cardioversion. Without a pulse: call Code;
immediate defibrillation.
First Drug: With a pulse: Amiodarone, Lidocaine. Without a pulse: Defibrillate first. Then:
Epinephrine 1 mg* IV/IO, Amiodarone 300 mg* IV/IO then any additional doses are 150
mg* IV/IO.