A 58 yo patient has called the ambulance, as he is having palpitations and is feeling unwell. He has a past medical history of ischaemic heart disease with two coronary stents placed 10 years earlier. He has a kidney transplant and also has significant vascular issues, with a recent forefoot amputation.
On ambulance arrival, he is conscious, but feels unwell. He is having multiple short runs of ventricular tachycardia(VT). They are self limiting and he never loses consciousness. However they are progressively becoming more frequent and longer in duration. Paramedics give a bolus of 150 mg of Amiodarone, following which the patient’s blood pressure drops. As per their protocols they commence an Adrenaline infusion. The blood pressure improves, however the episodes of VT are now becoming more prolonged. DC Cardioversion is attempted, but is unsuccessful. A further 150mg of Amiodarone is given. What would you do?