
Overview
This module describes the emergent management of tachycardia, where the patient has a palpable pulse.
Indications
Contraindications
Patient information and consent
The management of tachycardia requires monitoring, administration of medication, and possibly synchronised cardioversion. Ensure that you explain your findings and decisions to the patient as you go along. Some patients may be haemodynamically unstable and unable to understand; communicate with family members if present. See Synchronised Cardioversion for specific patient information.
Preparation
Tachycardia management management may be an emergency procedure. Always:
Site & Positioning
The patient should be lying flat on their back on a firm surface. There should be space behind the head of the bed for staff to stand to give rescue breaths if the patient deteriorates.
Procedure
Follow medical asepsis with non-sterile gloves.
Troubleshooting
I am unsure about the ECG diagnosis and how to manage this patient.
The exact ECG diagnosis of the rhythm is less important or urgent in unstable patients, who require emergency management as soon as tachycardia is confirmed. Stable patients require workup and ECG identification, and should preferably be referred early to cardiology for management.