1. Tachyarrhythmia Approach to management: 1. Determine if there is a pulse – If no pulse, initiate management for pulseless arrest 2. Determine if patient is stable 3. Determine if it is a wide complex or narrow complex tachycardia

2. Narrow Complex Tachycardia Supraventricular Tachycardia Abrupt onset In infants, rate ≥ 220 beats/min In older children, rate ≥ 180 beats/min No P waves No beat to beat variability Sinus Tachycardia Gradual onset, varies with activity In infants, rate < 220 beats/min In older children, rate < 180 beats/ min P waves visible

3. PALS Tachycardia Algorithm. Kleinman M E et al. Circulation 2010;122:S876-S908 Copyright © American Heart Association

4. Management of SVT Vagal manoeuvres Pharmacologic – Adenosine 0.1mg/kg rapid IV push – Amiodarone Electrical cardioversion – Synchronised – 0.5-1 J/kg, may increase to 2J/kg Consider causes