vagal maneuvers
continued tachycardia? YES -> adenosine 6 mg rapid IV push
continued tachycardia after 1-2 min? YES -> adenosine 12 mg rapid IV push
continued tachycardia after 1-2 min? YES -> repeat adenosine 12 mg rapid IV push
wide complex? YES -> synchronized cardioversion algorithm NO -> verapamil 2.5-5 mg IV
continued tachycardia after 15-30 min? YES -> verapamil 5-10 mg IV
continued tachycardia after 15-30 min? YES then consider