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Unstable Tachycardia (Wide or Narrow Complex)

Date Last Search Run: Jan 14, 2025
Table last updated: Apr 02, 2022
Data last added: Mar 19, 2022

Recommendation RECOMMENDATION FOR INTERVENTION
STRENGTH OF EVIDENCE FOR INTERVENTION   SUPPORTIVE (Green) NEUTRAL (Yellow) AGAINST (Red) NOT YET GRADED (White)
1 (strong evidence exists)        
2 (fair evidence exists)      
3 (weak evidence exists)  


Interventions

Electrical Cardioversion
Level Direction Primary Outcome Patient/Process Setting Reference
III Supportive (Green) Successful cardioversion Process PH-Paramedic Cowley A, Cody D, Nelson M. The Epidemiology and Effectiveness of Synchronized Cardioversion in a UK Prehospital Setting: A Retrospective Cross-Sectional Study. Prehosp Disaster Med 2021; 36(4):440–4. Medline
III Supportive (Green) Termination of SVT Patient PH-Paramedic Smith G., Taylor DM., Morgans A., Cameron P. Prehospital synchronized electrical cardioversion of a poorly perfused SVT patient by paramedics. Prehosp Disaster Med 2013; 28(3):301-304. Medline
III Neutral (Yellow) Successful cardioversion Patient ED-MD Chang AK., Lent GS., Grinberg D. Double-dose external cardioversion for refractory unstable atrial fibrillation in the ED. Am J Emerg Med 2008; 26(3):385.e1-3. Medline
III Neutral (Yellow) Rhythm conversion Patient Gerstein NS., McLean AR., Stecker EC., Schulman PM. External Defibrillator Damage Associated With Attempted Synchronized Dual-Dose Cardioversion. Ann Emerg Med 2018; 71(1):109-12. Medline

Vagal Maneuvers
Level Direction Primary Outcome Patient/Process Setting Reference
III Neutral (Yellow) Termination of SVT Patient PH-Paramedic Smith G., Taylor DM., Morgans A., Cameron P. Prehospital synchronized electrical cardioversion of a poorly perfused SVT patient by paramedics. Prehosp Disaster Med 2013; 28(3):301-304. Medline


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