What is the protocol for unstable patients with hypotension in Rapid A-Fib and A-Flutter?

The correct approach for managing unstable patients with hypotension in Rapid A-Fib and A-Flutter is to administer 1L of Normal Saline and prepare for push dose epinephrine. This protocol focuses on addressing the immediate concern of hypotension, which is critical in unstable patients. Rapid Atrial Fibrillation (A-Fib) and Atrial Flutter (A-Flutter) can lead to decreased cardiac output and resultant hypotension due to ineffective atrial contraction and irregular ventricular response.

Administering Normal Saline can help to increase intravascular volume, supporting blood pressure. Push dose epinephrine is commonly utilized to increase systemic vascular resistance and improve perfusion in states of hypotension, which is paramount in acute care settings when patients are unstable.

This strategy prioritizes stabilization of the patient's hemodynamic status while addressing the immediate needs caused by the rapid atrial rhythms. It helps ensure that blood flow to vital organs is maintained while further management for the arrhythmia can be planned.