Advanced Cardiovascular Life Support (ACLS) Practice Exam

A 56-year-old man with a pulse of 130/min has a wide-complex tachycardia on his ECG. After establishing an IV and obtaining the ECG, what is the next action?

1. Administer beta-blockers

2. Seek expert consultation

3. Prepare for synchronized cardioversion

4. Continue monitoring

The correct answer is: Seek expert consultation

In a situation where a patient presents with wide-complex tachycardia and a significant pulse rate, the priority is to assess the stability of the patient. If the patient is unstable — which can be indicated by signs such as altered mental status, significant hypotension, or other evidence of poor perfusion — immediate intervention is critical. While seeking expert consultation can be appropriate in certain scenarios, particularly in unstable cases where advanced interventions may be necessary, the correct course of action would typically involve preparing for synchronized cardioversion. This is because synchronized cardioversion is the recommended treatment for unstable patients experiencing rapid wide-complex tachycardia, such as ventricular tachycardia. The need for immediate treatment with synchronized cardioversion arises from the fact that wide-complex tachycardia can lead to significant hemodynamic instability. Thus, it is essential to provide timely intervention to prevent deterioration. In stable cases, other options such as medication or consultation may be more appropriate but are secondary to addressing acute instability, which is likely what the scenario leans towards suggesting. In summary, while considering further consultation is an important part of overall patient management, the immediate actions in cases of unstable wide-complex tachycardia necessitate an intervention