rate too slow? YES -> bradycardia algorithm

rate too fast? YES -> tachycardia algorithm

systolic BP < 100 mmHg? YES -> hypotension/shock algorithm

diastolic BP < 110? YES -> dobutamine 2-20 µg/kg/min IV improved BP? YES -> add dopamine 2.5-20 µg/kg/min IV

diastolic BP > 110? YES -> signs of ischemia or suspected MI? YES -> nitroglycerine 10-20 µg/min IV (titrate up if ischemia persists) NO -> nitroprusside 0.1-5.0 µg/kg/min IV

consider further treatment

• furosemide 0.5-1.0 mg/kg IV
• morphine 1-3 mg IV
• nitroglycerine 0.3-0.4 SL (repeat q5min x2) (if not already on IV drip)
• nitroglycerine 10-20 µg/min IV (if systolic BP >100 and not already on)
• nitroprusside 0.1-5.0 µg/kg/min IV (if systolicBP >100 and not already on)
• dopamine 2.5-20 µg/kg/min IV (if systolic BP < 100)
• dobutamine 2-20 µg/kg/min IV (if systolic BP > 100)
• intubate and provide positive airway pressure (PEEP/CPAP)