k. If ventricular tachycardia (ventricles beating together but very fast) is seen
with "Quick-look" paddles, follow this procedure:
(1)
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.
(3)
If synchronized cardioversion is ineffective, repeat cardioversion.
NOTE:
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
this procedure:
(1)
(2)
Insert an endotracheal tube or an esophageal airway for optimal
ventilation.
(3)
Start an IV infusion.
NOTE:
Defibrillation is NOT used with asystole because there is no electrical activity
in the heart to correct.
(4)
Give 0.5 mg to 1 mg intravenously of epinephrine.
(5)
Administer 1.0 mg of atropine intravenously. Repeat one time in 5
minutes.
(6)
Repeat epinephrine at five minute intervals.
(7) In rare instances, a temporary pacemaker can be used to restore the
paced rhythm of the heart.
MD0571
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