Supra-ventricular Tachycardia

Supraventricular Tachycardia

Blog written by – Dr Ashly Liu

Summary

If unstable: (1) ELECTRICITY (2) Pharmacology

If stable: (1) Vasovagal manoeuvres  (2) Pharmacology (3) ELECTRICITY (if unstable)

1. Is the patient stable or unstable?

Primary Survey to assess for haemodynamic instability

Airway: airway maneuvers (chin lift, jaw thrust) and adjuncts (oro/nasopharyngeal)

Breathing: RATES (Resp rate, auscultation, Tracheal deviation, Effort, Saturation)

Circulation: HR, BP, IVC (bloods, fluids), ECG

Disability: Diabetes, drugs, documentation

Exposure: temperature, bleeding

Fluids: fluid status
Glucose: BGL

The purpose of the primary survey would be to assess and manage issues as they arise concurrently. At any point, if a patient goes into arrest, CPR should commence immediately. 

Signs of Adverse Features and Instability

• Heart failure
• Myocardial Ischaemia
• Shock
• Syncope

2. Is the QRS narrow (<0.12s)?

If QRS complex <0.12s, then supraventricular tachycardia

If regular rhythm

1. Vasovagal Manouvre
2. Adenosine
3. Call cardiology

If irregular rhythm, then likely atrial fibrillation

3. Is the QRS broad (>0.12s)?

If VT, consider amiodarone

Source: ALS2 Manual