Wide Complex Tachycardia: SVT with Aberrancy vs VT, WPW, TCA OD, and Hyperkalemia ECG Interpretation

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[@Ericlpaulson]

ACLS allows for the use of Adenosine on any regular monomorphic WCT to rule out SVT with BBB. Vtach won’t respond to adenosine but you will see a slowing of the rate with SVT - maybe even conversion if your lucky. Brugada’s Algorithm isn’t hard to learn, but you are right about statistics here - 19/20 times it will be Vtach and age and history are your biggest indicators.

[@osamaqazi5301]

Do we shock hyperkalemia.?? If EKG shows a wide complex rhythm and patient is hemodynamically unstable but we know for sure in the labs that this is hyperkalemia??

[@Scopeducation]

Very good question! A Very wide complex tachycadia (over 1 big box wide) is thought to be a tox/metabolic issue and suggests hyperkalemia so that is when you go down that pathway by giving calcium and the rest of the treatment plan. Electical synchronized cardioversion is the safest way to deal with any deadly arrhythmias not induded by an electrolyte issue. So to answer your question, if you have a wide complex tachycardia and labs prove it's not HyperK, then shock it!