| What is the basis for the advisory guidelines in the Standard Treatment Workflow (STW)? | expert opinions and available scientific evidence | This STW has been prepared by national experts of India with feasibility considerations for various levels of healthcare system in the country. These broad guidelines are advisory, and are based on expert opinions and available scientific evidence. There may be variations in the management of an individual patient based on his/her specific condition, as decided by the treating physician. There will be no indemnity for direct or indirect consequences. Kindly visit the website of ICMR for more information: (icmr.gov.in) for more information. ©Indian Council of Medical Research, Ministry of Health & Family Welfare, Government of India. Standard Treatment Workflow (STW) | 198 | summary | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651144_6_tachyarrhythmia.pdf | These broad guidelines are advisory, and are based on expert opinions and available scientific evidence. | 1 | page=1,block=1 | 0.700 | valid |
| What is one of the conditions to consider when evaluating tachycardia? | hemodynamic instability | • Is there hemodynamic instability? • Can the heart rate be explained by clinical condition (Fever etc.) • Is the arrhythmia incessant or episodic? • Is there an underlying structural heart disease? • Is this a re-entrant arrhythmia or does it involve an automatic focus? • Tachycardia out of proportion to clinical condition • Irregular heart rate • Unexplained heart failure Sudden termination No effect Adenosine Slow and unmask 0. J/Kg synchronized for suspected SVT/VT 2-4 J/Kg for VF; should not be synchronized 12 lead ECG recorded after termination of the tachycardia showing a clear substrate in the form of pre-excitation Sinus tachycardia, Junctional ectopic tachycardia, | 11 | list | 0.740 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651144_6_tachyarrhythmia.pdf | • Is there hemodynamic instability? • Can the heart rate be explained by clinical condition (Fever etc.) • Is the arrhythmia incessant or episodic? • Is there an underlying structural heart disease? • Is this a re-entrant arrhythmia or does it involve an automatic focus? • Tachycardia out of proportion to clinical condition • Irregular heart rate • Unexplained heart failure Sudden termination No effect Adenosine Slow and unmask 0. |
| What alternative is suggested if an ECG machine is unavailable? | a video recording of the monitor | Adenosine • Proximal access • Connect three-way to I/V port • Adenosine 100-200 mcg/Kg rapid I/V push followed immediately by 5-10 ml saline bolus • Always record Electrocardiogram (ECG) during administration • Always record Electrocardiogram (ECG) after treating the arrhythmia also Stable Unstable Connect to Defibrillator paddles Common Stable/minimally distressed Good perfusion Narrow QRS tachycardia Regular Wide QRS tachycardia Irregular Wide QRS tachycardia Uncommon Distressed In shock Poor perfusion; pulse not felt Obtain 1. 12 lead ECG; Limb leads alone if child does not cooperate (If ECG machine is unavailable, a video recording of the monitor must be obtained) 2. Reliable I/V access; Proximal sites preferred Hemodynamic Stability Defibrillation 2 J./Kg Synchronized Cardioversion 1J/Kg July/ 2024 | 626 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651144_6_tachyarrhythmia.pdf | 12 lead ECG; Limb leads alone if child does not cooperate (If ECG machine is unavailable, a video recording of the monitor must be obtained) 2. | 1 | page=1,block=55 | 0.700 |
| What diagnostic tool is recommended after termination of tachycardia? | 12 lead ECG recorded after termination of the tachycardia | • Is there hemodynamic instability? • Can the heart rate be explained by clinical condition (Fever etc.) • Is the arrhythmia incessant or episodic? • Is there an underlying structural heart disease? • Is this a re-entrant arrhythmia or does it involve an automatic focus? • Tachycardia out of proportion to clinical condition • Irregular heart rate • Unexplained heart failure Sudden termination No effect Adenosine Slow and unmask 0. J/Kg synchronized for suspected SVT/VT 2-4 J/Kg for VF; should not be synchronized 12 lead ECG recorded after termination of the tachycardia showing a clear substrate in the form of pre-excitation Sinus tachycardia, Junctional ectopic tachycardia, | 518 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651144_6_tachyarrhythmia.pdf | J/Kg synchronized for suspected SVT/VT 2-4 J/Kg for VF; should not be synchronized 12 lead ECG recorded after termination of the tachycardia showing a clear substrate in the form of pre-excitation Sinus tachycardia, Junctional ectopic tachycardia, | 1 | page=1,block=13 | 0.700 |
| What is the disclaimer mentioned in the Standard Treatment Workflow (STW)? | There will be no indemnity for direct or indirect consequences. | This STW has been prepared by national experts of India with feasibility considerations for various levels of healthcare system in the country. These broad guidelines are advisory, and are based on expert opinions and available scientific evidence. There may be variations in the management of an individual patient based on his/her specific condition, as decided by the treating physician. There will be no indemnity for direct or indirect consequences. Kindly visit the website of ICMR for more information: (icmr.gov.in) for more information. ©Indian Council of Medical Research, Ministry of Health & Family Welfare, Government of India. Standard Treatment Workflow (STW) | 391 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651144_6_tachyarrhythmia.pdf | There may be variations in the management of an individual patient based on his/her specific condition, as decided by the treating physician. There will be no indemnity for direct or indirect consequences. Kindly visit the website of ICMR for more information: (icmr.gov.in) for more information. | 1 | page=1,block=1 |
| What is the recommended dose of adenosine for administration? | Adenosine 100-200 mcg/Kg rapid I/V push | Adenosine • Proximal access • Connect three-way to I/V port • Adenosine 100-200 mcg/Kg rapid I/V push followed immediately by 5-10 ml saline bolus • Always record Electrocardiogram (ECG) during administration • Always record Electrocardiogram (ECG) after treating the arrhythmia also Stable Unstable Connect to Defibrillator paddles Common Stable/minimally distressed Good perfusion Narrow QRS tachycardia Regular Wide QRS tachycardia Irregular Wide QRS tachycardia Uncommon Distressed In shock Poor perfusion; pulse not felt Obtain 1. 12 lead ECG; Limb leads alone if child does not cooperate (If ECG machine is unavailable, a video recording of the monitor must be obtained) 2. Reliable I/V access; Proximal sites preferred Hemodynamic Stability Defibrillation 2 J./Kg Synchronized Cardioversion 1J/Kg July/ 2024 | 62 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651144_6_tachyarrhythmia.pdf | Adenosine • Proximal access • Connect three-way to I/V port • Adenosine 100-200 mcg/Kg rapid I/V push followed immediately by 5-10 ml saline bolus • Always record Electrocardiogram (ECG) during administration • Always record Electrocardiogram (ECG) after treating the arrhythmia also Stable Unstable Connect to Defibrillator paddles Common Stable/minimally distressed Good perfusion Narrow QRS tachycardia Regular Wide QRS tachycardia Irregular Wide QRS tachycardia Uncommon Distressed In shock Poor perfusion; pulse not felt Obtain 1. |
| Where can more information about the Standard Treatment Workflow (STW) be found? | the website of ICMR for more information: (icmr.gov.in) | This STW has been prepared by national experts of India with feasibility considerations for various levels of healthcare system in the country. These broad guidelines are advisory, and are based on expert opinions and available scientific evidence. There may be variations in the management of an individual patient based on his/her specific condition, as decided by the treating physician. There will be no indemnity for direct or indirect consequences. Kindly visit the website of ICMR for more information: (icmr.gov.in) for more information. ©Indian Council of Medical Research, Ministry of Health & Family Welfare, Government of India. Standard Treatment Workflow (STW) | 468 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651144_6_tachyarrhythmia.pdf | Kindly visit the website of ICMR for more information: (icmr.gov.in) for more information. | 1 | page=1,block=1 | 0.700 | valid |
| Which organization is associated with the Standard Treatment Workflow (STW)? | Indian Council of Medical Research, Ministry of Health & Family Welfare, Government of India | This STW has been prepared by national experts of India with feasibility considerations for various levels of healthcare system in the country. These broad guidelines are advisory, and are based on expert opinions and available scientific evidence. There may be variations in the management of an individual patient based on his/her specific condition, as decided by the treating physician. There will be no indemnity for direct or indirect consequences. Kindly visit the website of ICMR for more information: (icmr.gov.in) for more information. ©Indian Council of Medical Research, Ministry of Health & Family Welfare, Government of India. Standard Treatment Workflow (STW) | 547 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651144_6_tachyarrhythmia.pdf | ©Indian Council of Medical Research, Ministry of Health & Family Welfare, Government of India. | 1 | page=1,block=1 | 0.700 | valid |
| What is preferred for reliable intravenous access during treatment? | Proximal sites | Adenosine • Proximal access • Connect three-way to I/V port • Adenosine 100-200 mcg/Kg rapid I/V push followed immediately by 5-10 ml saline bolus • Always record Electrocardiogram (ECG) during administration • Always record Electrocardiogram (ECG) after treating the arrhythmia also Stable Unstable Connect to Defibrillator paddles Common Stable/minimally distressed Good perfusion Narrow QRS tachycardia Regular Wide QRS tachycardia Irregular Wide QRS tachycardia Uncommon Distressed In shock Poor perfusion; pulse not felt Obtain 1. 12 lead ECG; Limb leads alone if child does not cooperate (If ECG machine is unavailable, a video recording of the monitor must be obtained) 2. Reliable I/V access; Proximal sites preferred Hemodynamic Stability Defibrillation 2 J./Kg Synchronized Cardioversion 1J/Kg July/ 2024 | 701 | factual | 0.490 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651144_6_tachyarrhythmia.pdf | Reliable I/V access; Proximal sites preferred Hemodynamic Stability Defibrillation 2 J./Kg Synchronized Cardioversion 1J/Kg July/ 2024 | 1 | page=1,block=55 | 0.700 |
| What is the recommended treatment for a patient with poor perfusion and no felt pulse? | Defibrillation 2 J./Kg | Adenosine • Proximal access • Connect three-way to I/V port • Adenosine 100-200 mcg/Kg rapid I/V push followed immediately by 5-10 ml saline bolus • Always record Electrocardiogram (ECG) during administration • Always record Electrocardiogram (ECG) after treating the arrhythmia also Stable Unstable Connect to Defibrillator paddles Common Stable/minimally distressed Good perfusion Narrow QRS tachycardia Regular Wide QRS tachycardia Irregular Wide QRS tachycardia Uncommon Distressed In shock Poor perfusion; pulse not felt Obtain 1. 12 lead ECG; Limb leads alone if child does not cooperate (If ECG machine is unavailable, a video recording of the monitor must be obtained) 2. Reliable I/V access; Proximal sites preferred Hemodynamic Stability Defibrillation 2 J./Kg Synchronized Cardioversion 1J/Kg July/ 2024 | 748 | factual | 0.490 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726651144_6_tachyarrhythmia.pdf | Reliable I/V access; Proximal sites preferred Hemodynamic Stability Defibrillation 2 J./Kg Synchronized Cardioversion 1J/Kg July/ 2024 | 1 | page=1,block=55 | 0.700 |