|
.
|
EKG Characteristics
|
|
Rhythm
|
Regular
with sudden onset and termination of rapid rate
|
| Rate
|
150
- 200
|
| P
wave
|
May
or may not be seen
|
| PR
interval
|
If
seen it is usually short
|
| QRS
complex
and T wave
|
normal
configuration
|
|
|
Clinical Findings
|
-
Symptoms
are frequent and include palpitations, anxiety,
lightheadedness
-
Angina may
occur due to decrease coronary artery blood flow and increased
myocardial oxygen consumption
-
Cardiac
output may drop
|
|
Etiology
|
-
Can
occur at any age and with no underlying heart disease.
-
Can be due
to hyperthyroidism, smoking, caffeine, amphetamines, dig toxicity.
|
|
Interventions
|
,
| 1.
Vagal maneuvers |
-
Methods
to stimulate baroreceptors located in internal carotid
arteries and the aortic arch. Stimulation of
these receptors results in reflex stimulation of vagus
nerve and release of acetylcholine.
Acetylcholine slows conduction through the AV node,
resulting in slowing of the heart rate.
-
coughing,
bearing down, squatting, breath-holding, immersion of
face in ice water, stimulation of gag reflex.
-
Carotid
sinus message
|
| 2.
Medications |
- Adenosine - Drug of
choice
- Rapid action, half life is only a few seconds
- 6 mg rapid IV Bolus- followed by 20 cc of NS
- Head of bed slightly elevated
- Will see pause - sometimes up to 6 seconds, tell pt
to cough
- Patient may complain of feeling hot.
- Verpamil - not used very
often
|
3.
Synchronous Cardioversion - patient must be sedated
4. Over-drive suppression w temporary pacemaker |
.
|
|