give adenosine 3 mg IV fast | |
give adenosine 12 mg IV slow push (over 1-2 mins) | |
give metoprolol 5 mg IV and repeat if necessary | |
perform vagal maneuvers |
continue monitoring and seek expert consultation | |
perform emergency synchronized cardioversion | |
administer nitroglycerine 0.4 mg sublinqual or spray | |
administer lidocaine 1 mg/kg IV | |
perform elective synchronized cardioversion with presedation |
repeat amiodarone 300 mg IV | |
give magnesium sulfate 1 to 2 g IV diluted in 10 mL D5W given over 10 -20 mins. | |
lidocaine 1 to 1.5 mg IV and start infusion 2 mg/minute | |
repeat amiodarone 150 mg IV | |
give sodium bicarb 50 mEq IV |