Vagal maneuvers: Difference between revisions
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==Modified positional valsalva== | |||
{{Modified positional valsalva}} | |||
==Carotid sinus massage== | ==Carotid sinus massage== | ||
*Ideal duration of 15 seconds<ref>Appelboam, A, et al. Randomised Evaluation of modified Valsalva Effectiveness in Re-entrant Tachycardias (REVERT) study. BMJ, 2014; 4(3):e004525.</ref> | *Ideal duration of 15 seconds<ref>Appelboam, A, et al. Randomised Evaluation of modified Valsalva Effectiveness in Re-entrant Tachycardias (REVERT) study. BMJ, 2014; 4(3):e004525.</ref> | ||
*Auscultate to rule out bruits in carotid artery before performing | *Auscultate to rule out bruits in carotid artery before performing | ||
*Perform ONE side at a time | *Perform ONE side at a time | ||
==Pediatrics== | ==Pediatrics== | ||
Revision as of 16:03, 23 January 2017
Modified positional valsalva
Modified positional valsalva
Set-up
- 10ml syringe with plunger
- Two assistants - one to adjust head of bed and another to raise/lower legs.
Steps
- Position patient with legs flat and head of bed to 45°
- Have patient attempt to blow out plunger of 10ml syringe (or Valsalva around 40mmHg) for 15 seconds
- Quickly reposition patient's head of bed to flat and have the other assistant raise legs to 45° for another 15 seconds
- Return head of bed to 45° and continue to monitor for resolution for 1 minute
- Repeat if needed
Carotid sinus massage
- Ideal duration of 15 seconds[1]
- Auscultate to rule out bruits in carotid artery before performing
- Perform ONE side at a time
Pediatrics
- Often successful with ice application to face
See Also
References
- ↑ Appelboam, A, et al. Randomised Evaluation of modified Valsalva Effectiveness in Re-entrant Tachycardias (REVERT) study. BMJ, 2014; 4(3):e004525.