• Assess ABCs
• Secure airway
• Administer oxygen
• Start IV Attach monitor, pulse oximeter, and automatic B/P cuff
• Assess vital signs
• Review history
• Perform problem focused physical examination
• Order 12-lead ECG
• Order portable chest x-ray
• Vagal maneuvers (no carotid sinus massage in older patients or those with possible atherscelerosis)
• Adenosine 6mg rapid IV push. May repeat in 1-2minutes with 12mg dose if no response. May repeat 12mg dose once.
• If diagnostic efforts reveal ectopic or multifocal atrial tach or junctional tach: use beta blockers, calcium channel blockers, or Amiodarone. Do not cardiovert as it will not convert rhythm.
• If diagnostic efforts reveal PSVT: give Amiodarone 150mg IVP over 10-20 minutes followed by infusion. Consider cardioversion if drugs do not work.
• If diagnostic efforts reveal Afib or Aflutter: refer to Afib/flutter algorithm.
  

To: ACLS Intravenous Medicated Infusions