Modified positional valsalva: Difference between revisions
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#Position patient with legs flat and head of bed to 45° | #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. | #Have patient attempt to blow out plunger of 10ml syringe (or Valsalva around 40mmHg) for 15 seconds. | ||
# | #Then quickly reposition patients head of bed to flat and have the other assistant raise legs to 45° for another 15 seconds. | ||
#Return patient to head of bed at 45° and continue to monitor for resolution for 1 minute. | #Return patient to head of bed at 45° and continue to monitor for resolution for 1 minute. | ||
#Repeat if needed. | #Repeat if needed. | ||
Revision as of 01:39, 5 August 2016
Background
2015 REVERT Trial
- Found for SVT resolution to NSR:[1]
- Normal Valsalva - 17% resolution
- Modified Positional Valsalva - 43% resolution
- No adverse events or costs associated with Modified Positional Valsalva
Set-up
- 10ml syringe with plunger
- Two assistants - one to adjust head of bed and other 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.
- Then quickly reposition patients head of bed to flat and have the other assistant raise legs to 45° for another 15 seconds.
- Return patient to head of bed at 45° and continue to monitor for resolution for 1 minute.
- Repeat if needed.
Links
Modified Valsalva manoeuvre for supraventricular tachycardia
See Also
References
- ↑ Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. Appelboam, Andrew et al. The Lancet , Volume 386 , Issue 10005 , 1747 - 1753