Modified positional valsalva: Difference between revisions
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==Background== | ==Background== | ||
===2015 [[REVERT Trial]]=== | ===2015 [[REVERT Trial]]=== | ||
* | *Studied modified Valsalva for [[SVT]] conversion to [[NSR]]:<ref>Appelboam A. et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial [http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2815%2961485-4.pdf fulltext]</ref> | ||
**Normal Valsalva - 17% resolution | **Normal Valsalva - 17% resolution | ||
**Modified Positional Valsalva - '''43% resolution''' | **Modified Positional Valsalva - '''43% resolution''' | ||
Revision as of 17:39, 28 February 2019
Background
2015 REVERT Trial
- Studied modified Valsalva for SVT conversion to NSR:[1]
- Normal Valsalva - 17% resolution
- Modified Positional Valsalva - 43% resolution
- No adverse events or costs associated with 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