Adult Tachycardia Algorithm (With Pulse)
Note: This document provides a structured summary of the Adult Tachycardia Algorithm (With Pulse) for educational and reference purposes. It is not a substitute for certified ACLS training and adherence to the latest guidelines published by the American Heart Association (AHA) or other relevant governing bodies. Always consult the most current official guidelines.
Identify fast heart rate, perform brief assessment, look for causes.
Look for hypotension, altered mental status, shock, chest pain, heart failure.
Prepare for cardioversion, sedation if possible. Energy levels vary by rhythm type.
Measure QRS duration (>0.12 sec is wide).
Attempt vagal maneuvers. Adenosine 6mg, then 12mg. Consider antiarrhythmic infusions.
Consider Adenosine (if regular/monomorphic). Consider antiarrhythmic infusions (Procainamide, Amiodarone, Sotalol). Consider expert consult.
Review H’s and T’s: Hypoxia, Hypovolemia, Hypothermia, Hypo-/Hyperkalemia, Hydrogen ion (acidosis), Tamponade, Toxins, Tension pneumothorax, Thrombosis (coronary/pulmonary).
Consult Cardiology, Critical Care, or other specialists as needed based on rhythm, cause, and patient condition.
