• New Tachycardia with pulse Algorithm
• Patients stratified Stable or Unstable, then by Narrow or Wide QRS, then regular or irregular rhythm.
• 12 lead ECG done as early as possible
• Polymorphic VT should be treated as VF
• Algorithm includes evaluating for the 6 Hs and 5 Ts
• Adenosine dosage will decrease to 3mg if
  • Patient is taking dypyridamole or carbamazepine,
  • Patients with transplanted heart
  • If given by central venous access
• Amiodarone is recommended for Ventricular Rhythms
• New Biphasic energy level recommendations
  • Atrial Fibrillation
    • 100 J - 200 J Monophasic
    • 100 J - 120 J Biphasic
  • Atrial Flutter and other SVTs
    • 50 J - 100 J Monophasic
    • More data is needed before detailed comparative dosing recommendations for cardioversion with biphasic waveforms can be made
  • Monomorphic VT with a pulse/unstable
    • 100 J Monophasic- If no response to first shock, increase the joules on a stepwise fashion(100 J , 200 J, 300 J, 360 J)
    • There is insufficient data to recommend specific biphasic energy doses.