N.J. Admin. Code § 8:41-7.13

Current through Register Vol. 56, No. 21, November 4, 2024

Section 8:41-7.13 - Standing orders for unstable ventricular tachycardia

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

1. Assess and secure airway;

2. Establish IV access;

3. If the patient is conscious, strongly consider contacting the medical command physician for an order for sedation prior to cardioversion;

4. Perform a synchronized cardioversion at 100 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 200 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 300 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 360 joules or equivalent biphasic. Check the patient's pulse and cardiac rhythm after the shock;

5. If the rhythm is converted at any point, administer 1 mg/kg Lidocaine or Amiodarone 150 mg IV over 10 minutes. The antiarrhythmic agent shall be predetermined by the medical director, who shall notify OEMS of his or her choice prior to utilization on any vehicle; and

6. Contact the medical command physician.

N.J. Admin. Code § 8:41-7.13