HEARTSTART SKILLS Frasco's video: Pulseless Ventricular Tachycardia pVT

HIS Purkinjie Rate: 20-40bpm. Tachy Rate: more than 100bpm. Pulses must be verified to be absent before identifying this wide complex tachycardia to be Pulseless VT. This rhythm may or may not precede with pulses being present. But with this rate ventricular contraction does not allow ventricular filling therefor pulses are going to be absent at any given time. This rhythm can only last for a couple of minutes before turning into either VF or Asystole if no interventions are done immediately. Pulseless VT is treated the same way as Ventricular Fibrillation would in AHA ACLS 2016 Guidelines. CPR with immediate Defibrillatory shock is recommended. Biphasic Defibrillators: 120 - 200 Joules or recommended. Monophasic Defibrillators: 360 J (followed by 2 mins. CPR). Other secondary interventions can be started if IV/IO access has been established. Medications that can be given with Pulseless VT: - Epinephrine 1mg IVP/IO (1:10,000) every 3-5 mins. - Amiodarone 300mg IVP/IO for the 1st dose; 150mg IVP/IO for the 2nd dose (if not hypokalemic) - Lidocaine 1-1.5mg/kg IVP/IO 1st dose; 0.5-0.75mg/kg 2nd dose (if hypokalemic) Based on AHA ACLS 2016 Guidelines