N.J. Admin. Code § 8:41-7.15

Current through Register Vol. 56, No. 11, June 3, 2024

Section 8:41-7.15 - Standing orders for unstable narrow complex tachycardia (non-atrial fibrillation or non-atrial flutter)

(a) The following standing orders are authorized in the event that an adult patient presents with an unstable narrow complex tachycardia where the patient is unconscious or hemodynamically unstable:

1. Assess and secure airway;

2. Establish IV access (in the antecubital fossa, if possible);

3. If the patient is conscious and IV access has been established, administer Adenosine 6 mg rapid, followed by 20 cc normal saline solution rapid bolus;

4. If IV access cannot be established, if the patient is unconscious or if there is no response to the Adenosine, perform a synchronized cardioversion at 50 joules or equivalent biphasic. Check the patient's pulse and cardiac rhythm after the shock;

i. If the rhythm fails to convert, perform a synchronized cardioversion at 100 joules or equivalent biphasic. Check the patient's pulse and cardiac rhythm after the shock;

ii. If the rhythm fails to convert, perform a synchronized cardioversion at 200 joules or equivalent biphasic. Check the patient's pulse and cardiac rhythm after the shock;

iii. If the rhythm fails to convert, perform a synchronized cardioversion at 300 joules or equivalent biphasic. Check the patient's pulse and cardiac rhythm after the shock;

iv. If the rhythm fails to convert, perform a synchronized cardioversion at 360 joules or equivalent biphasic. Check the patient's pulse and cardiac rhythm after the shock; and

5. Contact the medical command physician.

N.J. Admin. Code § 8:41-7.15