SVT (was: trauma-list Digest, Vol 38, Issue 29)

[Bjorn, Pret]

This isn't trauma.

Diltiazem is contraindicated.  Unstable SVT gets DC cardioversion.  Try
vagal maneuvers while the paddles are charging.  Pharmaceutical
approaches are reserved for stable patients.

That said, SVT (stable or otherwise) does not typically present with a
rate of 160.  Slowing this modest degree of tachycardia, by whatever
means, would be unlikely to have much impact on cardiac output.

Perhaps sending someone for Cardizem was a clever means of stalling
whilst the patient got some O2 and fluids and a reasonable physical
exam.  If that was the case, then it worked.

Pret Bjorn, RN
Bangor, ME USA


-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Vickie
Sent: Monday, August 21, 2006 11:04 PM
To: trauma-list at trauma.org
Subject: RE: trauma-list Digest, Vol 38, Issue 29

Seeking information on experience/outcome giving Cardizem(Diltiazem) to
hypotensive patient. Some MD's say hold for SBP<90 others say give is
even
if SPB<70, had MD request order to give Cardizem (Diltiazem) with BP
52/44
to correct SVT with HR160 (rationale was if he could slow HR the BP
would
increase since heart was ineffectively perfusing). Med was not given due
to
pt converting on own; however, has created quite a difference in
opinions.
Any opinions or feedback appreciated.

V.Beckler, RN

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]
On Behalf Of trauma-list-request at trauma.org
Sent: Monday, August 21, 2006 7:00 AM
To: trauma-list at trauma.org
Subject: trauma-list Digest, Vol 38, Issue 29

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