Answer 3

Answer 3:
Consider synchronized cardioversion. The patient is "stable", at least his vital signs are, but he does have chest pain. Pads should be placed on the patient and paddles should be prepared for cardioversions if the patient should drop his BP or alter his mental status at any time.

Consider Adenosine to differentiate this from SVT. Most SVT will slow or convert with adenosine, but VT will remain refractory.

Lidocaine is the drug of choice initially, with up to 90% of episodes of VT successfully terminated. Review sustained VT with pulse algorithm.

O2, IV access, Lidocaine 1mg/kg, Lidocaine .5mg/kg every 8 min. until VT resolves, or up to 3mg/kg, Procainamide 20mg/kg until VT resolves or go up 1 gr, cardiovert as in unstable patient.