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Medical Pearls from the Internet Medical Association

VT and VF can be caused by ischemia, infarction, cardiomyopathy, toxicities; QRS complex is wide. Differential included SVT with aberrant conduction. Treatment in unstable patients: assume VT (not SVT with aberrant conduction) and cardiovert. Stable patients: IV amiodarone. For polymorphic VT, consider magnesium.

Comment: One of the principles of ACLS is that electrical shock is the final treatment for most tachycardic rhythms. If the patient has a pulse, cardiovert. If no pulse, defibrillate. The key treatment algorithms change fairly frequently, so it is essential to stay current with the latest American Heart Association ACLS guidelines and focus on principles. Always have a copy of the latest protocols on the crash cart.

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