You are dispatched to a local school for a 9-year-old child who is ill. He is conscious and alert, and tells you that he is lightheaded and that his chest feels funny. He denies pain, shortness of breath, or any other symptoms. His breath sounds are clear and equal bilaterally, and his skin is pink, warm, and dry. The cardiac monitor reveals a regular narrow-complex tachycardia at a rate of 200 beats/min. His BP is 100/58 mm Hg and his respirations are 20 breaths/min. You ask him to bear down, but this has no effect on his heart rate. In addition to supplemental oxygen, you should:
A: establish vascular access and give a 500 mL fluid bolus.
B: establish vascular access and give 130 mg of amiodarone.
C: establish vascular access and give 2.5 mg of adenosine.
D: give 2.5 mg of midazolam IM and cardiovert at 15 joules.
Answer: C: establish vascular access and give 2.5 mg of adenosine.
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