- Hypotension, altered mental status, signs of poor perfusion
- Synchronized cardioversion
- V-tach, A-fib, PSVT: 100j, 200j, 300j, 360j
- A-flutter: 50j, 100j, 200j, 300j, 360j
- Polymorphic V-tach: 200j, 300j, 360j or biphasic equivalents, based on manufacturers recommendations
- Consider procedural sedation if practical (Midazolam 2.5 mg IV or Diazepam 5 mg IV)