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Repost • @the_resuscitationist REVERT TRIAL & MODIFIED VALSALVA MANEUVER TECHNIQUE--> In a semi-recumbent position patients produce 40mmHg pressure for 15 seconds and then repositioned in a supine position with a passive leg raise immediately after the valsalva strain. (REVERT TRIAL). In patients with stable supraventricular tachycardia (SVT), valsalva maneuvers are recommended as one of the initial maneuver to help with cardioversion. SUCCESS RATE--> of this valsalva maneuver alone is documented at 5 – 20%. The next option for patients who still remain in SVT are pharmacologic options. NOTE: Adenosine briefly stops all conduction through the AV node, which causes patients to feel a sense of doom or like they are about to die. Increasing venous return and vagal stimulation by laying patients supine and elevating their legs may increase the rate of conversion and is simple, safe & cost effective. RESULTS--> 428 patients with SVT included in primary analysis Primary Outcome: Return to NSR at 1 min STANDARD VALSVA: 37/214 (17%) MODIFIED VALSALVA : 93/214 (43%) ABSOLUTE DIFFERENCE = 26.2% NNT = 3 BOTTOM LINE: Please consider this as a first line treatment approach option for stable SVT! NOTE: any unstable patient (hypotension, altered, chest pain, hypoxia, CV collapse) gets immediate SYNCHRONIZED CARDIOVERSION! 🎥 @yourheartdoc . #heart #ems #paramedic #cardiac #doctor #dr #doc #rn #nurse #medical #medicine #er #emergency #hospital #teach #learn #education #student #study #video #svt #heartbeat #cardiology #race #fast #flip #research #ebm | Paramedicine 101
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