Which of the following is part of the management for Adult Unstable Ventricular Tachycardia?

• A. Defibrillation at 360 J
• B. Beta-blocker infusion
• C. Synchronized cardioversion
• D. Immediate gastric lavage

Answer: (C)

In adults who are unstable with ventricular tachycardia, the priority is to restore hemodynamic stability quickly with synchronized cardioversion. Delivering a shock that is timed to the R wave prevents triggering another dangerous rhythm while the patient still has a pulse, which helps convert the tachycardia to a stable rhythm and improves perfusion. Defibrillation at a fixed energy is used when the patient is pulseless or in cardiac arrest (no organized rhythm), not when there is a pulse and the patient is unstable. A beta-blocker infusion isn’t appropriate right away in an unstable patient because it can lower blood pressure and reduce cardiac output when the patient needs rapid rhythm control and perfusion. Immediate gastric lavage has no role in this acute cardiac emergency. So synchronized cardioversion is the appropriate immediate intervention.