View source for Supraventricular Tachycardia

==Section 4 - CARDIAC 4.07==
====CONSIDER MEDICAL ETIOLOGY OF SVT AND REFER TO APPROPRIATE PRACTICE PARAMETER:====
* Heart failure, [[Acute Cardiogenic Pulmonary Edema Pneumonia|PULMONARY EDEMA (4.11)]].
* Hypovolemia, [[Shock|SHOCK (5.13)]].
* Side-effects of other drugs, etc.

[[Initial Medical Assessment and Care|INITIAL MEDICAL CARE (2.01)]] - OXYGEN @ 100% via NRB mask.

====STABLE NARROW COMPLEX TACHYCARDIA:====
* Initiate large bore IV, preferably at antecubital fossae
* Administer [[Antiarrhythmics|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, [[Antiarrhythmics|ADENOSINE]] 12 mg RAPID IVP followed immediately by a rapid 10-20 ml saline flush (Maximum dose 18 mg)

====UNSTABLE:====
{| class="wikitable"
|-
! 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 [[Antiarrhythmics|ADENOSINE]]6 mg RAPID IVP. If unrelieved, consider sedation with [[Analgesia and Sedation|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.'''''

[[Category:Cardiac|0407]]