k. If ventricular tachycardia (ventricles beating together but very fast) is seen
with "Quick-look" paddles, follow this procedure:
Administer lidocaine in the dosage 50 to 100 mg IV bolus.
(2) If the patient is coping with the rhythm, perform synchronized
cardioversion with an electrical charge of 50 joules, a low energy charge. The object is
to try to shock the ventricles into normal rhythm.
NOTE: Sedate the casualty who is awake if there is time.
If synchronized cardioversion is ineffective, repeat cardioversion.
These definitions are important to remember. Synchronized cardioversion is a
timed electro shock delivered to a patient, the shock triggered by the R wave
of the patient's electrocardiogram. Defibrillation is a non-timed electro shock
delivered to a patient.
(4) Continue treatment as for unmonitored ventricular fibrillation, but
cardiovert rather than defibrillate.
l. If asystole (absence of heartbeat) is seen with "Quick-look" paddles, follow
Insert an endotracheal tube or an esophageal airway for optimal
Start an IV infusion.
Defibrillation is NOT used with asystole because there is no electrical activity
in the heart to correct.
Give 0.5 mg to 1 mg intravenously of epinephrine.
Administer 1.0 mg of atropine intravenously. Repeat one time in 5
Repeat epinephrine at five minute intervals.
(7) In rare instances, a temporary pacemaker can be used to restore the
paced rhythm of the heart.