Uploaded April 2009 | Updated September 2026, 3 weeks ago
Rate: greater than 100 bpm
P waves: None
QRS: wide greater than 0.12
ST segment and T wave have opposite polarity to R wave
Patients can be stable or unstable with this rhythm depending on the ventricular rate. The slower the rate, the more stable the patient is. The faster the rate, the more unstable the patient is. Such rhythm can become pulses and ACLS algorithm per VF protocols must be initiated immediately. Most common causes are chronic hypoxemia (COPD), hypokalemia, Myocardial Infarction, and toxins.
INTERVENTION: If Stable
- Keep airway patent, support breathing, keep O2Sat 94-99%, PETCO2 35-40 mm Hg
- Start peripheral IV, 12-Lead ECG
- Administer Amiodarone 150 mg IV/IO diluted in 50-100 mL of D5W given over 10 minutes (If patient is not hypokalemic)
- Administer Lidocaine 1-1.5 mg/kg IV/IO (if patient is hypokalemic)
INTERVENTION: If Unstable
- Consider sedation prior to cardioversion
- Administer Synchronized Cardioversion 100 J
Based on AHA ACLS 2016 Guidelines
Rate: greater than 100 bpm
P waves: None
QRS: wide greater than 0.12
ST segment and T wave have opposite polarity to R wave
Patients can be stable or unstable with this rhythm depending on the ventricular rate. The slower the rate, the more stable the patient is. The faster the rate, the more unstable the patient is. Such rhythm can become pulses and ACLS algorithm per VF protocols must be initiated immediately. Most common causes are chronic hypoxemia (COPD), hypokalemia, Myocardial Infarction, and toxins.
INTERVENTION: If Stable
- Keep airway patent, support breathing, keep O2Sat 94-99%, PETCO2 35-40 mm Hg
- Start peripheral IV, 12-Lead ECG
- Administer Amiodarone 150 mg IV/IO diluted in 50-100 mL of D5W given over 10 minutes (If patient is not hypokalemic)
- Administer Lidocaine 1-1.5 mg/kg IV/IO (if patient is hypokalemic)
INTERVENTION: If Unstable
- Consider sedation prior to cardioversion
- Administer Synchronized Cardioversion 100 J
Based on AHA ACLS 2016 Guidelines
