Just wanted to share this, I learned this vagal maneuver about a month or so ago and so far it has worked wonders!! The downside is it requires that the patient on a bed/Stretcher, although I suppose it may work if they are sitting.
Have the patient take a deep breath in and hold it while trying to lift both legs up off stretcher at the same time.
I know this sounds silly, but trust me when I say it works to vagal them!
I had a patient just the other day in an SVT in the ED and I had her do this, she converted to a sinus rhythm almost instantly. This patient had tried vasalva at home multiple times without success.
I am posting this becuase none of the other nurses in the ER had even heard of this vagal maneuver, so I wanted to share it for others who may not have heard about it.