Now the tech of cardio algorithm seems to confuse a lot of people. But I'm here to help you out. Let's make this nice and easy. Let's break this down. So here's the tips to identifying what we're what we're dealing with and how to treat it. So, here we go, we need to determine is that tech a cardia?

Regular or irregular? Is the QRS complex, narrow, or is the QRS complex wide. And then finally, is your patient, symptomatic or asymptomatic? So once we determine all of those, we can aggressively treat our patient. So typically, what I like to say is unstable gets electricity. That's how I remember it.

So if the patient is unstable, and they're in V tech with a pulse SVT a fib a flutter, the recommendation is synchronized cardioversion. So unstable tachycardia gets electricity, the different settings for synchronized cardioversion are going to vary based on the patient, the rhythm, the physician, and what type of monitor you're using, but your instructor will go over that with you. So just remember, unstable gets electricity. And here's how we treat stable. So let's say we have stable v TAC for some crazy reason it's a, it's a regular monomorphic wide complex tachycardia. And your patient doesn't have any complaints.

All you see is this crazy rhythm up there, it freaks you out. But the patient remains stable. what they'd like us to do is go get an expert consultation, they want us to call somebody who knows more than we do to determine what we need to do for this patient. Because if we just go all willy nilly and try and think oh, I'll try this, we can actually hurt them or send them into cardiac arrest. So your treatment for stable v TAC is going to be expert consultation. Now your treatment for stable lsvt or a narrow QRS complex and narrow complex tachycardia as long as the patient room main staple, and the heart rate is about 150 beats a minute or greater and that QRS complex is narrow and regular.

There's some different things that we can try to help this patient out. The first thing we should always consider is a vago maneuver or valsalva maneuver, what we want to do is have our patients stimulate their own Vegas nerve, and hopefully we can break that and allow the heart to stop and kind of reset itself. So you can have them breathe through a straw, you can have them pushed down on your stomach, or you push down on their stomach. You can also have them bear down like they're making a bowel movement, but those are considered vago maneuvers that we should try those first on a stable lsvt patient. Now, if that doesn't work, and a lot of times those vagal maneuvers won't work, then we need to administer adenosine. adenosine is a fantastic drug.

The way adenosine works is once it's introduced into the body. We push it very rapidly because the half life is about 10 seconds. It's done. Push it fast and push it as Close to the heart as possible. What it does, it goes right to the AV node with just the pathway of communication between the atria and the ventricles. And what it does is it shuts everything down temporarily for about five seconds or so.

They'll either go a systolic or severely Breda, Kartik, while at heart is resetting itself, and then when the adenosine wears off the patient's heartbeat or heart will start to beat again. Now, a couple things to remember during the treatment of what we suspect is SVT is that it might not be SVT SVT we can't truly call lsvt until we rule out to other arrhythmias that might be hiding within svt. I know it sounds confusing, but SVT can be hiding rabbit a fib or rabbit a flutter. And the way for us to determine what it really is, is actually to use that adenosine and do a continuous EKG monitoring before during and after the administration of adenosine and if we if we see a February 8 flutter during the last part of this phase, then we're going to treat it differently. adenosine typically fixes SVT only, not rabid a fib or rapid a flutter.

And we have two doses of adenosine and two doses only the American Heart Association took out the third dose about five years ago. So the first dose is six milligrams rapid IV push, and the second dose is 12 milligrams, so we only have six and 12. And if they don't respond to that, we're probably going to consider going into cardioversion because the drugs just aren't aren't working. Another rhythm or README to talk about is going to be Tor sod's Tor starts to point. It's also called an irregular or polymorphic wide complex tachycardia. This is a very dangerous arrhythmia is typically caused by hypo magnesium or low magnesium the electrolytes are off.

So the initial treatment for Tor sods is going to be max sulfate and if the max sulfate isn't working or the patient becomes severely compromised or goes into cardiac arrest. Our next treatment now is defibrillation. And even if they have a pulse, we're going to defibrillate this person simply because if we synchronize cardiovert it, it won't sync up because in order to synchronize cardiovert, somebody the monitor has to find perfect are waves and put those little dots above them, so it won't find them during torsos, so the treatment for that is going to be unsynchronized. cardioversion, also known as defibrillation,