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2. Initial assessment and treatment Follow the ABCDE approach! Asses for adverse signs! Administration of high flow oxygen! Obtain intravenous access! Establish monitoring (ECG,BP,SpO2)! Record a 12-lead-ECG! Correct electrolyte abnormalities(K+,Mg+,Ca+)! Look for the cause of arrhytmia! 3. Initial assessment and treatment The treatment depends on the condition of the patient! (stable vs. unstable) Anti-arrhytmic drugs: slower in onset for stable patients without adverse signs Electrical treatment (CV or PM) for unstable patients 4. Adverse signs Shock pallor, sweating, cold extremities (increased sympathetic activity) impaired consciousness (reduced cerebral blood flow) hypotension (systolic BP