ADULT

SVT / Narrow Complex Tachycardia

Algorithm

 

Pulse oximetry, if oxygen saturation less than 95%:

► High flow oxygen by mask as tolerated

 

Heart Rate 100 up to 150: - if signs of Hypovolemia: (lungs clear, and no signs of CHF):

Normal Saline, infuse 250 mL, repeat to max of 1 liter

(assess lung sounds, discontinue fluid infusion if rales develop)

 

Heart Rate 150 and above: - if signs of Hypovolemia,

(lungs clear, and no signs of CHF):

Normal Saline, infuse 250 mL, repeat to max of 1 liter

 

If mild chest discomfort, lightheadedness, or diaphoresis: Attempt Valsalva maneuvers

Heart Rate > 150: after attempted Valsalva maneuver, give:


Adenosine 12 mg, rapid IVP over 1–3 seconds 

►Repeat once per standing orders for persistent SVT BHO - Adenosine with history of severe asthma

 

Heart Rate > 150 and: Cardiac chest pain, ALOC or BP under 90 systolic:


Synchronized Cardioversion:

 

Philips: 100 J initial shock - ►Zoll: 70 J initial shock

Philips: 200 J second shock - ►Zoll: 120 J second shock
 

– if no conversion on second shock.
BHO - Further Synchronized Cardioversion
Versed (Midazolam) BHO
 

***See Synchronized Cardioversion in Procedures Section***

Run continual rhythm strip during treatments

If pt. is unstable and “synch” does not work, defibrillate the pt

Call

M: 949-769-1162

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