ACLS review: SVT part 8

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Expert consultation
  • Seek expert consultation for tachycardias not responsive to medications
  • Seek consultation for long term management
  • Impaired Cardiac Function 
  • Synchronized cardioversion
Digoxin 10-15mcg/kg
Amiodarone: Give 150mg IV bolus over 10 minutes followed by a continuous infusion at 1mg/min for 6 hours and 0.5mg/min for 18 hours.

Diltiazem: 0.25mg/kg over 2 minutes. If ineffective, in 15 minutes may repeat 0.35mg/kg over 2 minutes. Followed by a maintenance infusion of 5-15mg/hr
Amiodarone
Dose Give 150mg IV bolus over 10 minutes followed by a continuous infusion at 1mg/min for 6 hours and 0.5mg/min for 18 hours.
Observe for hypotension and bradycardia


Expert Consultation
  • Stable patients may await expert consultation because treatment has the potential for harm.
  • Sequential use of 2 or more drugs may have adverse effects: bradycardia, hypotension, and torsades de pointes
  • Seek expert consultation for tachycardias not responsive to medications
  • Seek consultation for long term management

References

Aehlert, Barbara. ACLS Quick Review Study Guide, 2nd edition. Mosby, inc. St. Louis, Mo. 1994.
Robert W. Neumar, Charles W. Otto, Mark S. Link, Steven L. Kronick, Michael Shuster, Clifton W. Callaway, Peter J. Kudenchuk, Joseph P. Ornato, Bryan McNally, Scott M. Silvers, Rod S. Passman, Roger D. White, Erik P. Hess, Wanchun Tang, Daniel Davis, Elizabeth Sinz, and Laurie J. Morrison Part 8: Adult Advanced Cardiovascular Life Support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care  Circulation. 2010;122:S729-S767
Reviewed 2/28/16

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