Pediatric Advance Life Support: SVT Part 4

Vagal Maneuvers

·         May be attempted while waiting for cardioversion

·         Success depends upon the patient’s age and ability to cooperate

·         Increase parasympathetic tone thereby decreasing the patient’s heart rate

Note:  Carotid massage is usually ineffective in children; if it is attempted, it should be performed on only 1 side of the neck. Applying ocular pressure is contraindicated in all cases due to the risk of retinal detachment.

Vagal Maneuvers

·         Ice water application to the face

·        Older children may blow through a straw

·         Coughing

·         Valsalva maneuvers

Valsalva maneuver

·         Document the dysrhythmia before treating

·         Explain the procedure to the patient

·         Instruct the patient to inhale and hold their breath and:

·         Bear down as if to have a bowel movement, and to hold this position for 20-30 seconds

Broslow tape

Medication Dose Calculation

·         Use the child’s weight if it is known

·         If the child’s weight is unknown, it is reasonable to use a body length tape

·         No data regarding the safety or efficacy of adjusting the doses for obese patients