# Svt



## falcon-18 (Mar 12, 2009)

Hi, all

there is one female in ER she is chief complaint from chest pain when we put her on monitor, SVT rhythm, narrow QRS, B/P-130/85 HR 190 IV line is apparent and adenosin is ready but patient now altterd mental statues and B/P-65/35
and cool skin what you will do ? give adenosin or sync cardioversion ?


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## vquintessence (Mar 12, 2009)

zzzzzzzzzzzzzzzap.  Hope you're not waiting by the pt for an answer


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## vquintessence (Mar 12, 2009)

^^^ based on the little info ya gave, but I'm curious... were vagal maneuvers tried during the 1-2 minutes getting the drug and bolus ready?  A lot of ppl jump straight to Adenocard...

Seems like you're asking because they went ahead with Adenocard?


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## falcon-18 (Mar 12, 2009)

yes i forget that vagal maneuvers done but no affect


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## firecoins (Mar 12, 2009)

well they had some affect.  Look at the drop in BP.


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## falcon-18 (Mar 13, 2009)

firecoins said:


> well they had some affect.  Look at the drop in BP.



yes vagal maneuvers sometimes affected but to this pt not effect 

BP-low cns-altterd  skin cool all it is signs of unstable 

but i want know when pt unstable and IV LINE is ready what we will do go to cardioversion or vagal maneuvers then adenosin


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## GonnaBeEMT (Mar 13, 2009)

If she is still in SVT and her bp went down like that I would say to do synched cardioversion


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## Silverstone (Mar 13, 2009)

Stable = Adenosine
Unstable = Synchronized Cardioversion

I'm sure you know how to differentiate between stable and unstable.


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## falcon-18 (Mar 13, 2009)

Silverstone said:


> Stable = Adenosine
> Unstable = Synchronized Cardioversion
> 
> I'm sure you know how to differentiate between stable and unstable.



yes I know stable & unstable but pt come unstable after vagal maneuvers and

((IV LINE IS READY))

but- DR/ in ER said you must give adenosin becouse treatment of SVT is adenosin not 
cardioversion but if IV LINE is not ready you will do cardioversion

((BUT I WILL DO cardioversion becouse adenosin contraindication when hyoptesion))

Who is agree me?


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## reaper (Mar 13, 2009)

What country are you in? What is your protocol there?


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## falcon-18 (Mar 13, 2009)

reaper said:


> What country are you in? What is your protocol there?



 American Heart Guidelines


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## falcon-18 (Mar 13, 2009)

this doctor is new
But he embarrassed when I asked him this question. Is a new staff member. he is Not expert
he is just now taking (ACLS COURSE)

dont warry about this question

 close it 

thanks every body

falcon-18


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