Tachycardia and Bradycardia Algorithms Flashcards

A patient has a heart rate of 160 bpm with a narrow QRS complex and is hemodynamically stable. What is the first-line treatment?

Answer: Vagal maneuvers

Vagal maneuvers (e.g., Valsalva, carotid sinus massage) are the first-line treatment for stable narrow-complex tachycardia.

During the bradycardia algorithm, atropine fails to increase the heart rate. What is the next intervention?

Answer: Transcutaneous pacing or dopamine/epinephrine infusion

If atropine is ineffective for symptomatic bradycardia, transcutaneous pacing or vasopressor infusion (dopamine or epinephrine) should be initiated.

A 58-year-old patient has a heart rate of 190 bpm with a wide QRS complex and is pulseless. What is the correct action?

Answer: Defibrillation and CPR per VF/pVT algorithm

A pulseless wide-complex tachycardia is treated as ventricular fibrillation/pulseless VT — defibrillation and CPR per cardiac arrest algorithm.

Which of the following is NOT a sign of hemodynamic instability requiring immediate intervention in tachycardia?

Answer: Heart rate of 110 bpm at rest

A heart rate of 110 bpm alone does not constitute instability; signs like hypotension, altered mentation, and pulmonary edema indicate instability.

What is the maximum total dose of atropine recommended in the ACLS bradycardia algorithm?

Answer: 3 mg

The maximum total dose of atropine in the ACLS bradycardia algorithm is 3 mg (given as 0.5 mg doses every 3–5 minutes).

A patient presents with atrial fibrillation with rapid ventricular response at 145 bpm, BP 88/60. What is the most appropriate next step?

Answer: Synchronized cardioversion

Hemodynamically unstable atrial fibrillation with rapid ventricular response requires immediate synchronized cardioversion.

Which energy setting is recommended for synchronized cardioversion of atrial flutter?

Answer: 50–100 J

Atrial flutter typically responds to lower energy levels (50–100 J) for synchronized cardioversion compared to atrial fibrillation.