3.9: Supraventricular Tachycardia

Question 1

SVT Criteria and initial actions

Answer 1

• Aged >12
• SVT with ventricular rate >150
• Acquire a 12 lead ECG whenever feasible.
• Exclude the possibility that the rhythm is sinus tachycardia secondary to another clinical condition. Only use this section if the dysrhythmia appears to be the primary problem.
• Determine the level of cardiovascular compromise.

Question 2

Not compromised or is mildly compromised

Answer 2

• Try up to two Valsalva manoeuvres.
• Gain IV access and administer adenosine IV if the rhythm fails to revert and the patient has a history of recurrent SVT that is known to be responsive to
adenosine.

Question 3

If the patient is moderately compromised

Answer 3

• Try up to two Valsalva manoeuvres.

* Gain IV access and administer adenosine if the rhythm fails to revert.

Question 4

Severely Compromised, Obeys Commands

Answer 4

• Reconsider Diagnosis
• ? Valsalva
• IV Access
• 1mg/kg Ketamine (max 100mg)
• Cardiovert at max jules
• Repeat x 1 if no reversion
• Seek clinical advice if cardioversion fails.

Question 5

Severely Compromised, Unable to Obey Commands

Answer 5

Able to sync cadiovert?

• No –> Attach defib in AED mode
• Yes –> Cardiovert at max jules
• Repeat x 1 if no reversion
• Seek clinical advice if cardioversion fails.

Question 6

ICP back up must be requested if:

Answer 6

• • Moderate or severe compromise, and

Rhythm fails to revert following valsalva manoeuver