For sync cardioversion in symptomatic tachycardia, what is the order of energy settings typically used?

The correct answer highlights the standard protocol for energy settings in synchronized cardioversion for symptomatic tachycardia. Starting with 100 joules is appropriate as it is typically effective for most tachyarrhythmias. If the initial shock does not successfully restore normal rhythm, increasing the energy to 200 joules is the next logical step, as higher energy levels may be necessary for successful cardioversion, particularly in more resistant cases. If further attempts are needed, proceeding to the maximum available setting is indicated to maximize the chances of converting the arrhythmia to a normal sinus rhythm.

Using these energy levels—100, then 200, and finally the maximum setting—aligns with the established guidelines for managing tachycardic patients. The choices reflect different potential settings, but the correct sequence ensures a methodical approach that balances effectiveness with patient safety, as the energy levels increase systematically while following current best practices in emergency cardiac care.