In adult unstable really wide complex tachycardia, which medication is added if the rhythm is not V-tach?

• A. Push Dose Epinephrine
• B. Calcium Chloride
• C. Amiodarone
• D. Lidocaine

Answer: (A)

When facing an unstable, wide-complex tachycardia, the priority is to restore and maintain perfusion while you pursue definitive rhythm management. If the rhythm isn’t clearly ventricular tachycardia, you still need rapid support for blood pressure and organ perfusion as you move toward stabilization, such as synchronized cardioversion. Push-dose epinephrine provides quick, short-acting vasopressor and inotropic support to raise blood pressure and improve perfusion without delaying care. Calcium chloride targets calcium handling issues (like hyperkalemia or calcium channel blocker overdose) and doesn’t address the immediate need to stabilize circulation. Antiarrhythmics like amiodarone or lidocaine are useful for confirmed VT, but they aren’t the first step for hemodynamic stabilization when the rhythm’s exact nature isn’t VT. So the best choice is push-dose epinephrine to support circulation while you complete rhythm management.