Distinguishing wide complex tachycardia: a prehospital perspective

It is important to mention that not all rhythms are textbook presentations. Certainty exists only in degrees. While the diagnostic clues offered in this article may help to increase certainty as it pertains to diagnosing a WCT, they are not a replacement for continued investigation and discovery regarding cardiac anatomy, physiology and pathophysiology, nor can they be exacting and precise when taken as isolated events. But taken as a whole these clues can build a convincing case for correctly differentiating and treating a WCT. Diagnosing and treating WCTs can be challenging, but with the proper tools, an accurate diagnosis is well within the reach of prehospital care providers (see Table II for a concise summary of electrographical and clinical clues).