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Unstable ventricular tachycardia — RCPSC EM MCQ

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HardCardiovascular emergenciesUnstable ventricular tachycardiaRCPSC EM

A 50-year-old man with an ICD presents after three shocks. He is awake but pale, blood pressure is 88/54 mmHg and monitor shows regular wide-complex tachycardia at 180/min. IV access is established and pads are applied. What is the most appropriate next step?

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Correct answer: C — Perform synchronised cardioversion with sedation if feasible without delaying shock

Unstable monomorphic wide-complex tachycardia requires synchronised cardioversion. Sedation is appropriate if it does not delay therapy; amiodarone may be used for stable wide-complex tachycardia.

Reference: ACLS; Canadian Cardiovascular Society dysrhythmia guidance