Management of Acute Supraventricular TachycardiaIn
childrenConsider SVTHR not variable with activityAbrupt rate
changesHR not variable infants 220 bpm, children 180 bpmP waves
absent/abnormalQRS normal ( 0.08 sec)
Management of SVT w/ Pulses & Poor PerfusionConsider vagal
maneuvers (no delays)Adenosine 0.1 mg/kg (max. 6 mg) rapid
bolusfollow immediately with NS 5 ml flushMay give 2nd dose 0.2
mg/kg (max. 12 mg) if theres no response after 1-2
minORSynchronized cardioversion 0.5-1 J/kg; if not effective,
increase to 2 J/kg. Sedate if possibleVagal Maneuver
Firm circular massage on carotid sinus for 10 sec. usually just
below the angulus of mandible. Can be repeated on the opposite
sideORApply an ice pack to the face 30-60 secManagement of SVT
(contd)Seek for expert consultationAmiodarone 5 mg/kg IV over 20-60
minORProcainamide 15 mg/kg IV over 30-60 minManagement of SVT w/
Adequate PerfusionConsider vagal maneuversAdenosine 0.1 mg/kg (max.
6 mg) rapid bolusfollow immediately with NS 5 ml flushMay give 2nd
dose 0.2 mg/kg (max. 12 mg) if theres no response after 1-2
minConsult pediatric cardiologist, Synchronized cardioversion 0.5-1
J/kg; if not effective, increase to 2 J/kg. Sedate prior to
cardioversion
