Similar to the older format of the NYC REMAC protocols, the new and improved version also includes a general dysrhythmia protocol that refers out to specific sub-protocols based on the underlying dysrhythmia. Not a lot of take-home points here, but the ones that are in this broad introductory protocol are important –
If the dysrhythmia is, well, pulselessness, refer to the relevant cardiac arrest protocol
“unstable” dysrhythmias refer to ones in adults with hypotension or AMS; or ones in kids with hypotension for age, depressed mental status, or absent peripheral pulses
“stable” dysrhythmias refer to those that lack the above features
If you’re going to electrically cardiovert conscious patients, consider procedural sedation
That’s about it, aside from some considerations for joule settings based on specific equipment capabilities. Keep all of this in mind, though, as it will be important as we discuss specific dysrhythmias in the coming weeks! Until then, www.nycremsco.org or the protocol binder for more.
Dave