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CARDIOLOGY

SVT

Often used synonomously with AV nodal re-entry tachycardia (form of SVT)
The term supraventricular tachycardia (SVT) refers to any tachydysrhythmia arising from above the level of the Bundle of His, and encompasses regular atrial, irregular atrial, and regular atrioventricular tachycardias
- LITFL
PromptECG interpretation
ResponseTachycardia – rate 150-170, (Paeds case was 4yo at 260/min)
Narrow complex
Regular R-R intervals
No clear sinus P waves
Self-rate:
PromptDDx narrow complex tachycardia
ResponseAtrial flutter
AV node re-entry tachycardia
Atrial tachycardia
Junctional tachycardia
AV re-entrant tachycardia
Self-rate:
PromptManagement (Paeds)
ResponseSimple vagal manouvres
  • Ice packs on face
Adenosine (2nd line is verapamil, Definate No <1yo, controversial <5)
  • 0.1mg/kg >> 0.2mg/kg >> 0.3 mg/kg
DC cardioversion under sedation
  • 1j/kg then 2J/kg
Self-rate:
PromptPre arrival preparation SVT
ResponsePASTED, see p. 57
Self-rate:
PromptMgmt after adenosine fails
ResponseVerapamil 5mg slow IV push
(other options but don’t pay full marks)
Self-rate:
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