Unstable tachyarrhythmias
Part of ALS algorithm
cardioversion energies
| Rhythm | Energy for 1st shock | Subsequent shocks |
|---|---|---|
| AFib | Maximum | |
| AFlu, SVT | 70-120J | "Stepwise increases" |
| Pulsed VT | 120-150J | "Stepwise increases" |
If patient remains in unstable rhythm,
- loading dose amiodarone (300 mg intravenously over 10–20 minutes) (or procainamide 10–15 mg kg-1 over 20 minutes) and re-attempt electrical cardioversion.
- The loading dose of amiodarone can be followed by an infusion of 900 mg over 24 hours.