Supraventricular Tachycardia (SVT) 

SVT Strip


Any cardiac rhythm with a rate exceeding 100 beats/ min that originates above the branching part of the atrioventricular bundle, that is, in the sinus node, atria, or atrioventricular (AV) junction. Mosby (2009-02-11).


Characteristics

Rate 100-250 BPM
Rhythm Regular
P-Waves 1 positive P wave precedes each QRS complex in lead 2. P waves differ in shape from sinus P waves
PR Interval May be shorter or longer than normal.
QRS Duration 0.10 sec (2 1⁄2 small boxes) or less, unless an intraventricular conduction delay exists.


MEDS

Adenosine 6mg RIV bolus with 20ml NS flush.

If needed repeat after 1-2 min 

Adenosine 12mg RIV bolus with 20ml NS flush

Consider Diltiazem (Cal Chnl Blkr) .25mg/kg


Treatment 


Stable Pt

Monitor Diagnostic 12 lead

Oxygen 15 LPM NR mask
IV 18g AC
Vagal Maneuvers Cough or bear down 

Administer Meds Adenosine 6mg RIV bolus with 20ml NS flush. If needed repeat after 1-2 min Adenosine 12mg RIV bolus with 20ml NS flush Consider Diltiazem (Cal Chnl Blkr) .25mg/kg


Unstable Pt

Oxygen 15 LPM NR mask
IV 18g AC
Administer Meds

Sedation 

Etomidate .3mg/kg IVP over 30-60 sec. May repeat with 0.3mg/kg in 2 min IF NEEDED

Synchronized Cardioversion 50j, 100j, 200j, 300j, 360j, bi-phasic energy 

© Matt Dillard 2012