Tachycardia Algorithm - ACLS Review

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In this next lesson we move on to talk about the American Heart Associations (AHA) ACLS algorithm for Tachycardia. Once again, their recommendations provide us a simplified and systematic approach to dealing with this emergency and knowing what to do here is something that you want to get down without having to think about it.
**Full disclosure that this video is NOT associated with the American Heart Association (AHA) and is merely a review of the information provided in their guidelines. Additional resources can be found at: cpr.heart.org/en/resuscitatio...
0:00 Intro
1:25 Basics and Rhythms
2:34 Start of Algorithm
3:17 Decreased Perfusion?
5:11 Wide or Narrow QRS?
7:09 Assessment/Management Questions
7:39 Conclusion
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Check out these other great lessons and series of lessons below!
✅ Hemodynamics: • Hemodynamic Principals
✅ Shock: • Shock
✅ ECG/EKG Rhythm Interpretation: • ECG/EKG Interpretation
✅ ICU Drips: • ICU Drips
✅ ECMO: • ECMO
✅ CRRT: • CRRT Explained!
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#ICUAdvantage #ACLS #Tachycardia

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WOW! That is so amazing to hear. Super stoked and huge congratulations to you. You should be very proud as that is a huge accomplishment, and I'm happy to have been able to help in any way. Way to go!!

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Revisiting this again for my renewal tomorrow. Eddie, thank you for all you do! I recommend your channel all the time to nurses I work with, as well as to our new grad and nursing externs.

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As always, your approach and delivery of the information is so concise.👍🎯💯

[@greensahuaro2834]

Thanknyou! I learned form an ER doctor to run the WKG strip on slower speed to check for a P wave to differentiate between a sinusvtachnor SVT.

[@elizabethelliott7303]

This was extremely helpful for my last semester in nursing school. Thank you!

[@beckykline7241]

Hey!! Thanks for putting all these videos out here on YT!! I'm an ER nurse and it helps so much being able to brush up and remember all the little intricacies of CC management. Thank you!!

[@ICUAdvantage]

This is so great to hear Becky and happy to have been able to help in some way!

[@antoinearnellpalomo8583]

Thanks for your video lessons. I passed my acls and bls today. Great review. Thank you!

[@mariavespa3311]

This has been such a great resource for my ACLS class!! Thank you for breaking it down so thoughtfully.

[@ICUAdvantage]

Yay! Happy to hear this Maria! You are very welcome.

[@emilyovermyer9207]

Preparing for my ACLS class right now and your videos are so helpful- thank you for putting them together and sharing!!!

[@ICUAdvantage]

Absolutely my pleasure and happy to be able to help!

[@doremifasolatido-ro7zs]

This channel is one of the best. Im getting ready for my upcoming acls this month. Thanks

[@ICUAdvantage]

Thank you! Glad you like it and best of luck on ACLS!

[@lindsay3474]

Your videos are fantastic. I can't believe that I am just discovering them as I start my final term of nursing school. Currently preparing for ACLS and your videos have helped me so much. You explain concepts so clearly. You truly have a talent for teaching. Thank you!

[@ICUAdvantage]

Thank you so much for the kind words Lindsay! Wish you would have found the channel sooner, but glad you have found it and hopefully some good info here to carry with you moving forward. Lots of videos here at this point!

[@sarahnew2278]

Thank you for all your heart work in making these videos. I had a placement in ICU last year and watching your videos helped me so much in making the most of my placement, and I was even complimented on my knowledge thanks to your videos! I am now an RN starting in cardiology and mixed surgical this year and hope to transition into ICU next year. Much love from Australia and hope you are staying safe and well!

[@ICUAdvantage]

Wow what a great story Sarah! I'm humbled to hear this and truly happy to be able to help in any way I can. Wishing you the best in your new nursing journey and if you stay driven I have no doubt you will end up where you want to be. Thank you and much appreciation all the way to Australia! :)

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You helped me through Nursing school, a year later I’m still listening to you! ACLS today and I start in Neuro ICU/CCU next week. Your videos are a life saver! Thanks for all you do!

[@ICUAdvantage]

Thank you so much Christina! Congrats on the new ICU position. Really glad I’ve been of help for you! Appreciate you taking the time to drop a comment! 😊

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I will be taking my ACLS tomorrow and I am reviewing using your posts. Thanks alot

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Best of luck!!

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Awesome. Best of luck on ALS!

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[@ICUAdvantage]

Very cool. Glad to be able to help out and thanks for taking the time to pop in the comments Ryan!

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Aye, I'm a paramedic in making and watching these videos for clinicals that began last week

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Thank u so much.. it helps me a lot for my ACLS renewal this month.

[@ICUAdvantage]

All the best

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we love how you break it down

[@ICUAdvantage]

Thats so awesome to hear! I try my best to make it understandable so glad to hear its well received.

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Happy to be able to help.

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Taking ACLS tomorrow and appreciate your easy overview of all your ACLS Modules. Nice job!

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Happy to be able to help! Hope your ACLS went well!

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Awesome to hear! Again, glad to hear you enjoyed this one as well! :)

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Glad you enjoyed it!

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Glad you like them!

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Glad you liked it Burdette! Happy to help.

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Wow this is so great to hear. Wishing you all the best for your interview. You'll have to check back in and let me know how you did.

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@@darwajaalpad7896 Amazing to hear!! Congrats and thanks for the follow up.

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Thank you Rose! Happy to help!

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Thank you!

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Appreciate that!

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Just want to say thank you, helps so much. :)

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Fantastic! Happy to be able to help Andrew!

[@happylife9037]

Thank u very much the video is very understanding

[@mishaunsahebi6066]

Hey can you plz talk more on indications for amio? Guidelines have it in the algorithms but in any video I watch it seems it’s not widely used. Thanks!

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very clear. thank you

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This is great. Would you share a little about your nursing background

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Great video Eddie

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Thank you so much Justin!

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Great, as usual

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so much learnt in 8mins

[@nourelgamel7014]

Could you explain to me why under the “wide QRS yes” it says if regular and monomorphic then consider adenosine? Is the “regular” talking about the QRS? Thank you!!

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Great video!

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Thank you Michelle!

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Thank you sir.

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Most welcome

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[@anyahgilbert6193]

Please I haven't heard you talk about ventricular fibrillation isn't it a type of tachyarrhythmia?

[@craigbrown808]

New guide lines recommend adenosine 6mg 12mg only. Thanks this is great information

[@ICUAdvantage]

Ahhh yup, certainly missed that. I guess 6,12,12 is just too trained in my brain! Glad you liked the video and thanks for taking the time to leave a comment Craig.

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@@ICUAdvantage you are welcome

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Really precious informations you have helped us with Appreciating all the wonderful work you have done.. Thank you

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Thanks

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Thank you!!

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Youre welcome!

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Thank you

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You're welcome

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Nicely explained. You make it sound easy. Yet, I know it’s not.

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Last semester of RN school. CRNA school next!

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Love this

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Awesome!

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Very good

[@ICUAdvantage]

Thank you!

[@tckexpat]

Thanks for your videos. You mentioned atropine is contraindicated with brady from a MI and TCP would be preferred. It seems that since the heart is contracting from the TCP the myocardium would also use O2. Is O2 consumption less when using TCP, and if yes, is there any evidence of that? Just curious. Thanks

[@ICUAdvantage]

Great question. I believe there is, but I'll have to try and search around and see if I can find that. I think its less over activation with TCP vs atropine.

[@dkshows3968]

Can epinephrine 1mg combined with Amiodarone used when the patient is having pulse ss vT

[@ICUAdvantage]

Yeah, although just start with the epi and give it every 3-5 and then give the amio when you reach that point in the algorithm

[@nurseeducatorpk8445]

Great way to teach

[@ICUAdvantage]

Thank you!

[@yasmine4754]

Hi, I loved your video, and it was super helpful with the tachycardias. I was just wondering when you talked about the stable tachycardias from 5:11 - 6:00, you mentioned polymorphic tachycardia (Torsades), but polymorphic tachycardia would never be stable and would always be pulseless, right? Just wasn't sure why it was mentioned along with the stable tachycardias, but maybe I misunderstood something. Thank you! 👍🙂

[@ICUAdvantage]

Usually is unstable or pulseless, but have seen it stable for short periods before.

[@yasmine4754]

@@ICUAdvantage That's interesting! Thank you!

[@sashaconnie9431]

whats the difference between wide complex tachycardia and monomorphic vtachycardia?

[@ICUAdvantage]

Great question! So Vtach is a tachycardia with impulse generating from the ventricle. WCT, the easiest way to think about it would be a tachyarrhythmia, such as SVT, but with a bundle branch block. It can get more complex there, but its originating from higher up the chain, but some aberrancy is leading to the wide complex and not that it is originating in the ventricle like with vtach.

[@percivalmercado2594]

What does it really mean when you say UNSTABLE? What does i need to observe??? Pls acknowledge.

[@hi-yd4kw]

signs of shock like BP systolic less than 90mm, altered mental status, etc

[@gilbertleon8884]

If a patient is stable and in a Monomorphic Wide complex tachycardia, can we skip adenosine and go straight to Amiodarone 150mg over 10min? I’m not understanding why adenosine would be considered. Adenosine only slows conduction through the AV node.

[@marlonappolis7029]

Hi any explanation on issue about adenosine …why is it there and should it be given before amiodorone or can we skip adenosine and give Amiodorone first???

[@hi-yd4kw]

we want to slow the rhythm quickly and with adenosine its quick! amid is last resort because it does prolong QT

[@gborowme]

Thanks.🌺

[@ICUAdvantage]

You're welcome!

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thanks

[@ICUAdvantage]

You're welcome!

[@blessyponnachen9528]

Hi How do you create these kind of videos? Can you suggest the websites were you download these free stock images of medical or human organs or medical devices ?

[@ICUAdvantage]

I use Adobe Photoshop screen cast to an iPad and write with an Apple Pencil, then screen record with Quicktime. As for images, just search around. There are plenty of resources free and paid.

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Thanks 🙏❤️

[@ICUAdvantage]

You're welcome 😊

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Awesome

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What's your favorite medications for sedation? And what's the dose?

[@ICUAdvantage]

Sedation for what purpose? It certainly depends...

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😊 great

[@zacsa9416]

Hello.. thank you so much for this video, I have a question, I just had a patient with cardiac arrest that had the svt rythm and after pushing 6mg adenosine, the rythm was converted but after a while it slowed down gradually till complete asystole, despite our chest compression and epinephrine injection.. what should I do to prevent this situation? I mean the bradycardia.. thank you

[@doremifasolatido-ro7zs]

Transient Asystole is one of the side effect of adenosine

[@adr5617]

Are there any other ecg? legit question cause when u said if the person has wide QRS, then we wanna get a 12 lead ecg. So initially the person was already on another ecg? feel like its a dumb question :( Thank you for the answer in advanced.

[@ICUAdvantage]

Not a dumb question. So if the patient is on a bedside monitor (3 or 5 lead, or even pads on the defibrillator) then we are assessing the rhythm and if needed get the more involved 12-lead for more detail analysis.

[@adr5617]

@@ICUAdvantage wow! thank you for your answer :) im so happy it’s giving me light. i never have the experience after graduating and i really enjoy watching your videos. i might have more questions along the way and im forever grateful to you for sharing your knowledge. this is such a generous act. :)

[@blessyponnachen9528]

Do you get copyright strike for your videos if you use screenshots from Google website , images , ?

[@ICUAdvantage]

Theres some freedom to use stuff under the fair use statutes.

[@RS-ig1zr]

Are you sure about giving another dose of 12mg adenosine on top of the previous 12 mg given?

[@azuzayzamani416]

Yes. Agree. AHA 2020 recommends IV Adenosine 6mg &12mg.

[@ICUAdvantage]

Yup apparently I missed that update! Just 1 dose now. All these years of 6-12-12 in my head to retrain! haha

[@dinarosova9653]

Appreciate your videos very much...Question: V-tach with pulse is being referred in the tach algorithm as a tach with wide QRS complex? The treatment is antiarhythmic with anticipation of fast deterioration?...Thank You!

[@ICUAdvantage]

You got it! I should have clarified that better, but yup, 100% v-tach with a pulse is one of the wide-complex tachycardias mentioned :) As for treatment, yes anti-arrhythmic. While this isn't mentioned in the ACLS algorithm, cardio version may be the fix that cardiology looks to use if the anti-arrhythmic is ineffective. While some people can persist in a stable v-tach, more often than not, if left unchecked they can quickly decline.

[@dannyhansen7558]

If you do cardiovert, how many j’s?

[@ICUAdvantage]

Great question. So it can vary, depending on what and why, as well as you may need to increase joules if no effect. But generally start at around 50J and can go all the way up if needed.

[@Zizuthecreatorlamarwest]

It is so ironic how increased HR actually means decreased perfusion. I honestly find that fascinating.

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❤️❤️❤️🙏

[@ICUAdvantage]

Thank you!

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P

[@ICUAdvantage]

?

[@mmellinger3]

Thank you for breaking this down! This helped me SO much for my ACLS class!

[@ICUAdvantage]

Yay! So happy to hear this and happy to be able to help!