ACLS review: SVT part 3

Precautions for Carotid Sinus Massage

·         Avoid carotid massage in older adults

·         Never perform bilateral carotid massage

·         Listen for bruits before carotid massage- contraindicated if bruits are present

·         Should not be continued for more than 10 sec.

·         Patient should be on cardiac monitor

·         Should have IV access before attempting vagal maneuvers

Procedure for carotid sinus massage

·         Turn head to the left

·         Apply firm pressure over the right carotid bifurcation near the angle of the jaw

·         If unsuccessful, repeat with a 5- to 1- second rotary “massage motion”

·         If unsuccessful, turn the head to the right side and perform left carotid massage

Contraindications

·         Avoid in elderly

·         Carotid bruits

·         History of CVA

·         Recent MI or myocardial ischemia

Medications Used to Treat Stable (symptomatic) SVT

·         Adenosine

·         Calcium channel blockers (class 1)

·         Beta blockers (class 1)

·         Digoxin


Reviewed 2/28/16