Supraventricular Tachycardia - Revision history

Treloars at 23:40, 23 April 2020

2020-04-23T23:40:10Z

← Older revision		Revision as of 23:40, 23 April 2020
Line 9:		Line 9:
	====STABLE NARROW COMPLEX TACHYCARDIA:====		====STABLE NARROW COMPLEX TACHYCARDIA:====
	* Initiate large bore IV, preferably at antecubital fossae		* Initiate large bore IV, preferably at antecubital fossae
	* Administer [[~~Antiarrhythmics~~\|ADENOSINE]] 12 mg RAPID IVP, administered at a port closest to the IV site, followed immediately by a rapid 10-20 ml saline flush		* Administer [[Adenosine\|ADENOSINE]] 12 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 24 mg)		* If NO response in 2 minutes, [[Adenosine\|ADENOSINE]] 12 mg RAPID IVP followed immediately by a rapid 10-20 ml saline flush (Maximum dose 24 mg)

	====UNSTABLE:====		====UNSTABLE:====
Line 27:		Line 27:


	* If IV established prior to patient becoming UNSTABLE, may administer [[~~Antiarrhythmics~~\|ADENOSINE]] 12 mg RAPID IVP. If unrelieved, consider sedation with [[Analgesia and Sedation\|VERSED (2.04)]] if patient is conscious and proceed with below therapies.		* If IV established prior to patient becoming UNSTABLE, may administer [[Adenosine\|ADENOSINE]] 12 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'''		** '''SYNCHRONIZED CARDIOVERSION'''
	*** Initial recommended doses:		*** Initial recommended doses:

Treloars: /* STABLE NARROW COMPLEX TACHYCARDIA: */

2020-01-13T21:35:16Z

STABLE NARROW COMPLEX TACHYCARDIA:

← Older revision		Revision as of 21:35, 13 January 2020
Line 10:		Line 10:
	* Initiate large bore IV, preferably at antecubital fossae		* Initiate large bore IV, preferably at antecubital fossae
	* Administer [[Antiarrhythmics\|ADENOSINE]] 12 mg RAPID IVP, administered at a port closest to the IV site, followed immediately by a rapid 10-20 ml saline flush		* Administer [[Antiarrhythmics\|ADENOSINE]] 12 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)		* If NO response in 2 minutes, [[Antiarrhythmics\|ADENOSINE]] 12 mg RAPID IVP followed immediately by a rapid 10-20 ml saline flush (Maximum dose 24 mg)

	====UNSTABLE:====		====UNSTABLE:====

Treloars: /* UNSTABLE: */

2020-01-13T17:57:46Z

UNSTABLE:

← Older revision		Revision as of 17:57, 13 January 2020
Line 27:		Line 27:


	* 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.		* If IV established prior to patient becoming UNSTABLE, may administer [[Antiarrhythmics\|ADENOSINE]] 12 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'''		** '''SYNCHRONIZED CARDIOVERSION'''
	*** Initial recommended doses:		*** Initial recommended doses:

Treloars: /* STABLE NARROW COMPLEX TACHYCARDIA: */

2020-01-13T17:57:20Z

STABLE NARROW COMPLEX TACHYCARDIA:

← Older revision		Revision as of 17:57, 13 January 2020
Line 9:		Line 9:
	====STABLE NARROW COMPLEX TACHYCARDIA:====		====STABLE NARROW COMPLEX TACHYCARDIA:====
	* Initiate large bore IV, preferably at antecubital fossae		* 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		* Administer [[Antiarrhythmics\|ADENOSINE]] 12 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)		* 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)

Treloars at 15:44, 1 February 2018

2018-02-01T15:44:35Z

← Older revision		Revision as of 15:44, 1 February 2018
Line 36:		Line 36:

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

			[[Category:Cardiac\|0407]]

Treloars: /* SUPRAVENTRICULAR TACHYCARDIA (Heart Rate > 160 beats / minute) */

2012-05-03T14:37:30Z

SUPRAVENTRICULAR TACHYCARDIA (Heart Rate > 160 beats / minute)

← Older revision		Revision as of 14:37, 3 May 2012
Line 1:		Line 1:
	==Section 4 - CARDIAC 4.07==		==Section 4 - CARDIAC 4.07==
	=~~==SUPRAVENTRICULAR TACHYCARDIA (Heart Rate > 160 beats / minute)~~===		====CONSIDER MEDICAL ETIOLOGY OF SVT AND REFER TO APPROPRIATE PRACTICE PARAMETER:====
			* Heart failure, [[Acute Cardiogenic Pulmonary Edema Pneumonia\|PULMONARY EDEMA (4.11)]].
	CONSIDER MEDICAL ETIOLOGY OF SVT AND REFER TO APPROPRIATE PRACTICE PARAMETER:		* Hypovolemia, [[Shock\|SHOCK (5.13)]].
	* Heart failure, [[Acute Cardiogenic Pulmonary Edema Pneumonia\|PULMONARY EDEMA]] (4.11).
	* Hypovolemia, [[Shock\|SHOCK]] (5.13).
	* Side-effects of other drugs, etc.		* Side-effects of other drugs, etc.

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

	~~'''[[Initial Medical Assessment and Care\|INITIAL MEDICAL CARE]] (2.01) - [[Medical Gases\|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
	~~'''''~~STABLE ~~and SYMPTOMATIC~~:~~'''''~~		* 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)

	* Initiate large bore IV, preferably at ~~AC.~~
	* [[Antiarrhythmics\|ADENOSINE]] 6 mg RAPID IVP, administered at a port closest to the IV site, followed immediately by a rapid 10 ml saline flush.
	* If NO response in 2 minutes, [[Antiarrhythmics\|ADENOSINE]]12 mg RAPID IVP followed immediately by a rapid 10 ml saline flush~~. May repeat once in 2 minutes.~~ (Maximum ~~total~~ dose ~~30 mg)~~


	~~'''''UNSTABLE:'''''~~
	* If IV established prior to patient becoming UNSTABLE, may administer [[Antiarrhythmics\|ADENOSINE]]6 mg ~~RAPID IVP. If unrelieved, consider sedation with [[Sedative Hypnotics\|VERSED]] (2.04~~) ~~if patient is conscious and proceed with below therapies.~~
	* [[Cardioversion\|SYNCHRONIZED CARDIOVERSION]] @ 50 Joules. May repeat [[Sedative Hypnotics\|VERSED]], if necessary.
	* If NO response, [[Cardioversion\|SYNCHRONIZED CARDIOVERSION]] @ 100 Joules.
	* If NO response, [[Cardioversion\|SYNCHRONIZED CARDIOVERSION]] @ 200 Joules.
	* If NO response, [[Cardioversion\|SYNCHRONIZED CARDIOVERSION]] @ 300 Joules.

			====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
			\|}

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

	~~This Standing Order is divided between the care and treatment of the stable patient verses the unstable~~ patient. ~~As a matter of definition agreed upon by the Medical Directors~~, ~~the UNSTABLE~~ patient is ~~one who presents~~ with ~~any of the following:~~ '''''SIGNIFICANT CARDIAC, SUSPECTED CARDIAC, SIGNIFICANT DYSPNEA, ALTERED MENTAL STATUS, OR HYPOTENSION WITH SIGNS OF DECREASED TISSUE PERFUSION, OR SIGNIFICANT COMPROMISE OF AIRWAY, BREATHING, AND/OR CIRCULATION.'''''		* 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)

	'''If ~~the patient presents with one or more of the above UNSTABLE criteria~~, ~~[[Defibrillation\|DEFIBRILLATION]] should be administered to avoid delays associated with synchronization~~.'''		'''''Physician's Orders: If NO response, contact Medical Control for consult.'''''

Treloars: /* SUPRAVENTRICULAR TACHYCARDIA (Heart Rate > 160 beats / minute) */

2012-02-02T15:04:10Z

SUPRAVENTRICULAR TACHYCARDIA (Heart Rate > 160 beats / minute)

← Older revision		Revision as of 15:04, 2 February 2012
Line 8:		Line 8:


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

Treloars: Created page with "==Section 4 - CARDIAC 4.07== ===SUPRAVENTRICULAR TACHYCARDIA (Heart Rate > 160 beats / minute)=== CONSIDER MEDICAL ETIOLOGY OF SVT AND REFER TO APPROPRIATE PRACTICE PARAMETER..."

2012-02-02T15:03:35Z

Created page with "==Section 4 - CARDIAC 4.07== ===SUPRAVENTRICULAR TACHYCARDIA (Heart Rate > 160 beats / minute)=== CONSIDER MEDICAL ETIOLOGY OF SVT AND REFER TO APPROPRIATE PRACTICE PARAMETER..."

New page

==Section 4 - CARDIAC 4.07==
===SUPRAVENTRICULAR TACHYCARDIA (Heart Rate > 160 beats / minute)===

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) - [[Medical Gases|OXYGEN]] @ 100% via NRB mask.

'''''STABLE and SYMPTOMATIC:'''''

* Initiate large bore IV, preferably at AC.
* [[Antiarrhythmics|ADENOSINE]] 6 mg RAPID IVP, administered at a port closest to the IV site, followed immediately by a rapid 10 ml saline flush.
* If NO response in 2 minutes, [[Antiarrhythmics|ADENOSINE]]12 mg RAPID IVP followed immediately by a rapid 10 ml saline flush. May repeat once in 2 minutes. (Maximum total dose 30 mg)

'''''UNSTABLE:'''''
* If IV established prior to patient becoming UNSTABLE, may administer [[Antiarrhythmics|ADENOSINE]]6 mg RAPID IVP. If unrelieved, consider sedation with [[Sedative Hypnotics|VERSED]] (2.04) if patient is conscious and proceed with below therapies.
* [[Cardioversion|SYNCHRONIZED CARDIOVERSION]] @ 50 Joules. May repeat [[Sedative Hypnotics|VERSED]], if necessary.
* If NO response, [[Cardioversion|SYNCHRONIZED CARDIOVERSION]] @ 100 Joules.
* If NO response, [[Cardioversion|SYNCHRONIZED CARDIOVERSION]] @ 200 Joules.
* If NO response, [[Cardioversion|SYNCHRONIZED CARDIOVERSION]] @ 300 Joules.

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

This Standing Order is divided between the care and treatment of the stable patient verses the unstable patient. As a matter of definition agreed upon by the Medical Directors, the UNSTABLE patient is one who presents with any of the following: '''''SIGNIFICANT CARDIAC, SUSPECTED CARDIAC, SIGNIFICANT DYSPNEA, ALTERED MENTAL STATUS, OR HYPOTENSION WITH SIGNS OF DECREASED TISSUE PERFUSION, OR SIGNIFICANT COMPROMISE OF AIRWAY, BREATHING, AND/OR CIRCULATION.'''''

'''If the patient presents with one or more of the above UNSTABLE criteria, [[Defibrillation|DEFIBRILLATION]] should be administered to avoid delays associated with synchronization.'''