Supraventricular Tachycardia

From Protocopedia
Jump to: navigation, search

Section 4 - CARDIAC 4.07

CONSIDER MEDICAL ETIOLOGY OF SVT AND REFER TO APPROPRIATE PRACTICE PARAMETER:

INITIAL MEDICAL CARE (2.01) - OXYGEN @ 100% via NRB mask.

STABLE NARROW COMPLEX TACHYCARDIA:

  • Initiate large bore IV, preferably at antecubital fossae
  • Administer ADENOSINE 6 mg RAPID IVP, administered at a port closest to the IV site, followed immediately by a rapid 10-20 ml saline flush
  • If NO response in 2 minutes, ADENOSINE 12 mg RAPID IVP followed immediately by a rapid 10-20 ml saline flush (Maximum dose 18 mg)

UNSTABLE:

Definition of Unstable: Persistent Narrow Complex Tachyarrhythmia causing:
  • Hypotension or signs of decreased tissue perfusion
  • Significant dyspnea or significant compromise of the airway
  • Acute mental status change
  • Signs/symptoms of shock
  • Acute heart failure
  • Ischemic chest discomfort


  • If IV established prior to patient becoming UNSTABLE, may administer ADENOSINE6 mg RAPID IVP. If unrelieved, consider sedation with VERSED (2.04) if patient is conscious and proceed with below therapies.
    • SYNCHRONIZED CARDIOVERSION
      • Initial recommended doses:
        • If narrow and regular complexes 50-100 Joules biphasic
        • If narrow and irregular complexes 120-200 Joules biphasic
        • If wide and regular complexes 100 Joules biphasic
        • If wide and irregular complexes – use defibrillation dose (not synchronized)

Physician's Orders: If NO response, contact Medical Control for consult.