PSVT is one of the most common arrhythmia in emergency department. Rapid treatment is one of the crucial action in this field. Sometimes PSVT is resistent to common drugs such as Adenosin as first line or beta blockers such as metoral, sinous carotid massage is one of the rapid action in emergency department to stop PSVT by parasympathic stimulation.
So which one is better in action? massage or medication in first line?
Dear Ramin
sinous carotid massage is the first line in PSVT
Adenosin and verapamil is the second line
good luck
Verapamil can suppress cardiac contractility, while rapid bolus injection with adenosine might produce chest distress transiently.
I agree with Shiva. Sinous carotid massage or Valsalva are the first line. Adenosine is second line and verapamil second/third in patients with stable haemodynamics.
The attached paper is the 2015/ACC/AHA/HRS Guideline for the management of patients with SVT.
Either carotid sinus massage or Valsalva maneuver is the first line of choice. However, those methods are time-consuming and patient or the family always lose the patience of waiting for consequence. For young physicians in emergency room, adenosine injection to the patient involved appears to be an easy and safe alternative way to do.
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