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The patient has been moved to resus. Your junior colleague has attempted vagal manoeuvres and given intravenous adenosine at a dose of 6mg and then 12mg.
There was no effect from this treatment and they have asked you for advice. What is the most appropriate next option?
The patient has been managed so far with attempted vagal manoeuvres, adenosine at doses of 6mg, 12mg, and 18mg, followed by intravenous metoprolol in divided doses to a total of 15mg, with no effect on the rate or rhythm.
Her ECG shows a persisting narrow complex regular tachycardia.
According to the Resuscitation Council UK guidance (2021) which of the following options would be the most appropriate in the immediate management of this patient?
The patient remains with a persisting narrow complex regular tachycardia despite vagal manoeuvres and medical therapy. You speak with the patient and the decision is agreed for undergoing synchronised DC cardioversion.
Which initial energy will you select for this procedure?