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Chapter: Paediatrics: Resuscitation

Paediatrics: Treating supraventricular tachycardia

Algorithm for treating patient with supraventricular tachycardia, but not in shock

Treating supraventricular tachycardia

 

Attach cardiac monitor and check BP.

Algorithm for treating patient with supraventricular tachycardia, but not in shock

1 Trial of vagal manoeuvres

2 Adenosine

·   50–100microgram/kg given as a rapid IV push into the most central IV access available followed by fast IV flush

·   If no response, then 100–200microgram/kg

·   If no response, then increase at increments of 50–100microgram/kg to a maximum single dose of 500microgram/kg

3 Consider

·   Synchronous DC shock

·   Amiodarone (IV bolus over 10min) 5mg/kg

·   Procainamide (IV loading dose of 15mg/kg over 30–60min). Stop infusion if QRS widens or hypotension occurs

·   Flecainide (IV 2mg/kg bolus over 20min)

·   Seek advice

 

Algorithm for treating patient with SVT who is in shock

1a Attempt vagal manoeuvres but do not delay progress to step 2

1b If IV access is available give adenosine (see preceding algorithm) but do not delay progress to step 2

2 Synchronous DC shock

·   1J/kg

·   If no response, then 2J/kg

·   If no response, then 2J/kg

3 Consider using anti-arrhythmics (amiodarone)

4 Synchronous DC shock

·   Return to step 2 in the algorithm at 2J/kg

 

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Paediatrics: Resuscitation : Paediatrics: Treating supraventricular tachycardia |


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