Adult narrow complex tachycardia

Question 1

What are the treatments for narrow complex tachycardia?

Answer 1

Valsalva maneuver/modified Valsalva maneuver

Carotid sinus massage/carotid sinus pressure

Both the above treatments are for SVT

For unstable patients: synchronized cardioversion at 100 J, 120 J, 150 J, and 200 J.

For stable patients:

Adenosine:

6 mg, 12 mg, 12 mg for SVT patients. Each dose is administered followed by an immediate rapid 20 to 60 mL flush of normal saline. No additional doses required after heart rhythm returns to normal sinus rhythm.

Cardizem:

10 mg over two minutes. Repeat every five minutes to a max of 40 mg.

Contra indicated for WPW syndrome.