Paroxysmal supraventricular tachycardia: Difference between revisions
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==Treatment== | ==Treatment== | ||
#Unstable | |||
##Synchronized cardioversion 0.5-1.0 J/kg | |||
#Stable | |||
#Vagal | ##Vagal maneuvers | ||
#Adenosine | ##1st line: Adenosine | ||
##6mg IVP ( | ###6mg IVP; 12mg IVP (if initial dose failed) | ||
## | ##2nd line: | ||
## | ###CCB | ||
# | ####Dilt 15–20mg IV over 2min | ||
# | #####May give 25mg IV if inadequate response after 15min | ||
#####If IV bolus worked start IV infusion at 5–20mg/hr | |||
#####Contraindications: Hypotension, CHF | |||
###BB | |||
####MTP 5mg IV q5min x 3; give 50mg PO if IVP effective | |||
####Esmolol 500mcg/kg IV over 60s | |||
#####May give repeat bolus if inadequate response after 2-5min | |||
#####If effective start infusion at 50mcg/kg/min (titrate up to 300) | |||
==See Also== | ==See Also== | ||
Revision as of 06:47, 4 May 2011
Diagnosis
| Sx | Sinus Tach | SVT |
| Hx | volume loss | sudden onset |
| PE | dehydated | CHF-like |
| *HR | <180 | >180 |
| Variability | Yes | No |
*In infants HR cuttoff = 220
Treatment
- Unstable
- Synchronized cardioversion 0.5-1.0 J/kg
- Stable
- Vagal maneuvers
- 1st line: Adenosine
- 6mg IVP; 12mg IVP (if initial dose failed)
- 2nd line:
- CCB
- Dilt 15–20mg IV over 2min
- May give 25mg IV if inadequate response after 15min
- If IV bolus worked start IV infusion at 5–20mg/hr
- Contraindications: Hypotension, CHF
- Dilt 15–20mg IV over 2min
- BB
- MTP 5mg IV q5min x 3; give 50mg PO if IVP effective
- Esmolol 500mcg/kg IV over 60s
- May give repeat bolus if inadequate response after 2-5min
- If effective start infusion at 50mcg/kg/min (titrate up to 300)
- CCB
See Also
Cards: VTach vs Abberant SVT
Source
2/23/06 DONALDSON (adapted from Rosen), UpToDate