Cardioversion of UNSTABLE SVT

SVT aka SupraVentricular Tachycardia is a rapid ECG rhythm which EMTs and Paramedics will treat in the EMS setting. In this case, we have a patient sitting at rest with an extremely high heart rate.

With all ACLS rhythms we have to determine whether the patient is stable or unstable based upon their chief complaints, vital signs and mental status. I always tell my students that the vital signs/blood pressure of the patient is most hallmark sign to whether we proceed with stable treatment or unstable treatment. AHA recommends for SVT 50-100J's with synchronized cardioversion for unstable SVT.

Watch the synchronized cardioversion of this Unstable SVT here.

Be Great,

Evan, The Paramedic Coach®

#shorts #paramedic #cardiology

[dos_mas_]

This saved my life yesterday. I was in my most severe and long lasting episode of SVT where, for the first time, felt that I needed to go to urgent care. They called 911 immediately and EMT's arrived shortly after and administered two doses of adenosine with no effect, so they hit me with 200 joules from the defibrillator, which brought my heart rate down and then transferred by ambulance to ER for follow up. Getting shocked while fully conscious and aware was gnarly, but it successfully reset my heart. My family and I are so grateful for the quick response of the medical team that helped us yesterday.

[ca]

Wow!!
So that's how it's done.

[gregoryconquest]

Are there medications that can correct this?

[dianeboutilier]

I've had this done for my afib 2x. It worked, but was kinda disorienting when you wake up.

[jdb]

So if you were going to break this down into four steps it would be
Press sync
Get capture
Select power level
shock

[huwguyver]

@TheParamedicCoach I heard from one source that the patient has to be sedated to perform this procedure, but then I saw a YT video of a guy being successfully cardioverted while conscious, although I assume he had pain management on board.

In your experience what would you typically give a patient to prepare them for this procedure? Thanks!

[cameroncook]

Have you ever watched that old show Emergency??😁

[ca]

So the pads and leads are both on at this time??

[westmount]

Should do 50 joules…100 may be too much