Red flags
- Chest pain, shock, HF, altered mental state = adverse signs
- Pulseless → follow VF/VT arrest algorithm
- Torsades → Mg 2 g IV
First steps
- ABCDE + attach defib pads
- IV access
- Sedate if conscious (midazolam ± fentanyl)
Key investigations
- 12-lead ECG (rhythm identification)
- K+, Mg, troponin
Differentials
- VT vs SVT with aberrancy
- AF with WPW (irregular wide)
Initial management
- Narrow: sync shock 50-100 J; AF 120-200 J; flutter 70-120 J
- Wide (VT): 100-200 J biphasic
- Post-conversion: amiodarone 300 mg IV over 20 min then 900 mg/24 h
- Correct K+ >4.5, Mg >1
Referral
- Cardiology / EP for ablation or ICD assessment
AI clinical assessment
Enter patient details to generate evidence-based guidance.
This tool is for educational and clinical support only. It does not replace professional medical judgment or institutional protocols.
