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