(b)
Stable patient (blood pressure more than 90 mm Hg, systolic):
1 Perform vagal maneuvers.
2 If there is no response, administer verapamil in the dosage of
0.075 to 0.15 mg/kg body weight (maximum 10 mg) as IV bolus over a 1-minute period.
3 If the initial response is not satisfactory and a repeat dose is
required, administer at 0.15 mg/kg body weight (maximum 10 mg) 30 minutes after the
first dose.
4 If there is still no response, perform cardioversion or use other
drug therapy according to a doctor's order.
Figure 2-17. Atrial tachycardia.
e. Atrial Flutter.
(1) Analysis. Atrial rhythm is regular if the PP intervals are constant. The
ventricular rhythm is regular if the AV node conducts impulses in a constant pattern.
The ventricular rhythm is irregular if the AV node varies the pattern. In regard to the
heartbeat rate, the atrial rate is 250 to 350 heartbeats per minute. The ventricular
heartbeat rate depends on the ratio of impulses conducted to the ventricles. The P
waves have well defined "flutter" waves and a sawtooth appearance. The P-R interval
is not measured (impossible to determine). The QRS complex is less than 0.12
seconds.
Treatment.
(2)
(a) There is no treatment if the casualty is hemodynamically (having to
do with the movements of the circulation of blood) stable.
MD0571
2-21