Tachycardia (Narrow)

Question 1

How would you confirm narrow complex tachycardia?

Answer 1

• QRS <0.12 secs
• Absent or abnormal P waves
• Exclude AF, Atrial flutter unless rapidly deteriorating

Question 2

How do you perform the modified valsalva?

Answer 2

Patient semi-recumbant (45 degrees) –> forced expiration –> lay patient flat and raise legs for 15 seconds

Question 3

How do you perform an abdominal valsalva?

Answer 3

• Patient supine, blowing into 10ml syringe for 15 seconds

- Repeat x 2 @ 2/60 intervals (max 3 attempts)

Question 4

What can MICA perform/admin for a pt in SVT?

Answer 4

• Adenosine
• Synchronised cardioversion
• Sedation

Question 5

What do you do if a patient loses cardiac output during SVT?

Answer 5

Follow cardiac arrest CPG

Question 6

Recite the CPG for Tachycardia (Narrow complex).

Question 7

How many attempts can you have at valsalva?

Answer 7

Max 3 attempts

Question 8

What’s the different between modified and standard valsalva?

Answer 8

Modified - pt semi recumbent —> forced expiration and then lay flat and raise legs for 15 seconds

Standard (abdominal) patient supine, blowing into syringe for 15 seconds

Question 9

What will MICA do for SVT?

Answer 9

If BP < 90 - adenosine

If unstable synch cardioversion

Question 10

What do you do if your patient with SVT loses cardiac output?

Answer 10

Commence CPR

Question 11

What must you do you prior to commencing management for SVT?

Answer 11

Record a 12 lead ECG