Pediatric Advanced Life Support (PALS): Tachycardia With Pulse
PALS: Tachycardia
1. The initial evaluation is as follows: [1, 2, 3, 4]
Assess appropriateness for clinical condition (pulse present).
The heart rate is typically ≥150 bpm in tachyarrhythmia.
2. The initial intervention is as follows:
Maintain patent airway and assist breathing as needed.
Administer oxygen if hypoxemic.
Attach monitor/defibrillator.
Monitor blood pressure and oximetry.
3. Assess for signs of poor perfusion, as follows:
Hypotension
Acutely altered mental status
Signs of shock
Tachycardia with Poor Perfusion
1. Evaluate QRS duration, as follows:
Determine if narrow (≤0.09 seconds) or wide (>0.09 seconds).
For narrow QRS complex tachycardia, obtain 12-lead electrocardiography (ECG) or monitor.
References
Neumar RW, et al. Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015 Nov 3. 132 (18 Suppl 2):S315-67. [Medline].
Atkins DL, et al. Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015 Nov 3. 132 (18 Suppl 2):S519-25. [Medline].
de Caen AR, et al. Part 12: Pediatric Advanced Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015 Nov 3. 132 (18 Suppl 2):S526-42. [Medline].
American Heart Association. 2015 Handbook of Emergency Cardiovascular Care for Healthcare Providers. ISBN 978-1-61669-397-8. November 2015
