Adult SVT

Question 1

What are the care objectives for Adult SVT

Answer 1

• Rapid termination of life threatening arrhytmias and transport to a facility capable of definitive care
• Rapid transport to facilitate the treatment of the arrhytmia where treatment is not available in the prehospital environment
• Early termination of stable SVT where possible, following ECG capture

Question 2

What are 4 S&S of an unstable and rapidly deteriorating SVT patient

Answer 2

• Inadequate perfusion/shock (E.g. hypotension, pallor and diaphoresis)
• Acutely altered conscious state or loss of consciousness
• Ischaemic Chest pain
• APO

Question 3

What are the 4 steps of the modified valsalva

Answer 3

1. Lay semi-recumbent
2. Forced expiration 15 seconds
3. Lay patient flat and lift legs to 45degrees for 15 seconds
4. Return the patient to the semi-recumbent position

Question 4

What should be captured prior to a during valsalva?

Answer 4

12- lead ECG

Question 5

When is Valsalva contraindicated?

Answer 5

Blood pressure less than 90

Question 6

How many times can the valsalva be attempted

Answer 6

• can be repeated twice @ 2minute intervals (Max 3 attempts)

Question 7

What are the phases of the Valsalva Manauver?

Answer 7

Phase 1: Forced expiration against a closed glottis increase intrathoracic pressure
- Increased aortic pressure
- decrease in Heart rate
Phase 2: Increased intrathoracic pressure impededs venous return therefore reducing Aortic pressure
- Leads to increase Heart rate
Phase 3: Glottis opened and legs raised leads to increased venous return
- massive cardiac output and aortic pressure
- Innervates parasympathetic nervous symstem
- Drops heart rate