- BP, sats, RR, temp, consciousness?
- Any chest pain, breathlessness or dizziness?
- Can you do an ECG now?
Do now
- ECG: narrow or broad, regular or irregular?
- Adverse features? (shock, syncope, ischaemia, heart failure)
- Treat the cause: sepsis, bleeding, pain, PE, dehydration
- Correct K⁺ and Mg²⁺
Key doses
- Unstable: synchronised DC shock — senior / anaesthetics
- Stable SVT: vagal manoeuvres, then adenosine 6 → 12 → 18 mg IV
- Fast AF: rate control per BNF; treat the trigger
Typical adult doses — always check the BNF and your local guideline.
Call your senior if
- Any adverse feature
- Broad-complex tachycardia
- Not settling
Think of
- Sinus tachycardia (sepsis, bleeding, pain, PE, dehydration)
- AF / flutter
- SVT
- VT
Go deeper
The full walkthroughs behind this call.