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Narrow complex tachycardia shock — DipIMC MCQ

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HardResuscitationNarrow complex tachycardia shockDipIMC

A patient has a regular narrow-complex tachycardia at 210/min with confusion and systolic pressure 76 mmHg. What rhythm treatment is indicated?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: EPerform synchronised cardioversion with sedation if feasible

The best answer is “Perform synchronised cardioversion with sedation if feasible”. Hypotension and altered consciousness are adverse features caused by the tachyarrhythmia. RCUK recommends immediate synchronised cardioversion, with sedation or anaesthesia if feasible without delaying shock. Vagal manoeuvres or adenosine are appropriate for a stable regular narrow-complex tachycardia, while unsynchronised defibrillation risks inducing ventricular fibrillation when an organised pulse-producing rhythm is present.

Reference: Resuscitation Council UK, 2025 Adult advanced life support: https://www.resus.org.uk/professional-library/2025-resuscitation-guidelines/adult-advanced-life-support-guidelines