ALS algorithm

- Managing the patient with adverse signs

If a patient has an irregular narrow-complex tachycardia and you identify adverse features, which are putting them at risk of deterioration, then you should perform synchronised cardioversion.
Please refer to the topic ‘How to perform synchronised cardioversion’.
A picture of a patient in bed.

In the absence of contraindications, start anticoagulation initially with low-molecular-weight heparin or unfractionated heparin, at the earliest opportunity. You should ensure that you do not allow this treatment to delay cardioversion.

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References

See chapter 11 of the ALS manual for further reading about the tachycardia algorithm.

Essentials: Adverse features

Adverse features imply that a patient’s condition is unstable and at risk of deterioration. The following adverse features indicate that a patient is at risk of deterioration either wholly or partly because of their arrhythmia:

  • Shock
  • Syncope
  • Heart failure
  • Myocardial ischaemia

More information about adverse features can be found chapter 11 of the ALS manual and in the second topic in this module: How to apply the principles of treatment.

Algorithm: The tachycardia algorithm

The tachycardia algorithm is available in chapter 11 of the ALS manual.

The tachycardia algorithm is available in chapter 11 of the ALS manual.

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