protocol for management of haemodynamically stable ventricular tachycardia
Last reviewed 01/2018
The steps used in the resuscitation procedure are outlined:
- give high flow oxygen
- establish i.v. access
- check serum potassium; if less than 4 mmol/l:
- give up to 60 mmol potassium chloride at maximum rate of 30 mmol per hour
- if hypokalaemic, assume patient also to be hypomagnesaemic:
- give 10 mmol magnesium sulphate over 30 minutes (5 mls of 50% solution)
- give either:
- amiodarone 150 mg in 20 mls 5% solution over 10 minutes; OR
- lignocaine 50 mg over 2 minutes repeated every 5 minutes up to a maximum
of 200mg
- start a lignocaine infusion at 2 - 4 mg per minute
- if VT persists, obtain expert help; consider:
- cardioversion (i.e. synchronised DC shocks at monophasic energy levels of 100J:200J:360J or biphasic equivalents)
- further amiodarone 150 mg in 20 mls 5% dextrose over 10 minutes)