Modified positional valsalva: Difference between revisions

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==Set-up==
==Set-up==
[[File:Screen Shot 2016-08-04 at 6.14.06 PM.png|thumbnail]]
[[File:Screen Shot 2016-08-04 at 5.53.13 PM.png|thumbnail|right]]
*10ml syringe with plunger  
*10ml syringe with plunger  
*Two assistants - one to adjust head of bed and other to raise/lower legs.  
*Two assistants - one to adjust head of bed and another to raise/lower legs.  
 
==Steps==
==Steps==
#Position patient with legs flat and head of bed to 45°
#Position patient with legs flat and head of bed to 45°
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#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.  
[[File:Screen Shot 2016-08-04 at 6.14.06 PM.png|thumbnail]]
[[File:Screen Shot 2016-08-04 at 5.53.13 PM.png|thumbnail|right]]


==Links==
==Links==

Revision as of 01:55, 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

Screen Shot 2016-08-04 at 6.14.06 PM.png
Screen Shot 2016-08-04 at 5.53.13 PM.png
  • 10ml syringe with plunger
  • Two assistants - one to adjust head of bed and another to raise/lower legs.

Steps

  1. Position patient with legs flat and head of bed to 45°
  2. Have patient attempt to blow out plunger of 10ml syringe (or Valsalva around 40mmHg) for 15 seconds.
  3. Then quickly reposition patients head of bed to flat and have the other assistant raise legs to 45° for another 15 seconds.
  4. Return patient to head of bed at 45° and continue to monitor for resolution for 1 minute.
  5. Repeat if needed.

Links

Video explaination and demonstration of Modified Positional Valsalva

The Lancet: REVERT Trial

See Also

References

  1. Appelboam A. et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial fulltext