svt question

I'm confused (more so than usual)...could you please clarify? V tach and SVT (SUPRAventricular tachy.) are mutually exclusive. It's either one or the other. The length of time does not matter. Maybe I'm missing something?

Supraventricular Tachycardia

A generic expression for any tachycardia that originates above the BUNDLE OF HIS.

Ventricular Tachycardia

An abnormally rapid ventricular rhythm with wide QRS complexes, usually in excess of 150 per minute. It is generated within the ventricle, below the BUNDLE OF HIS, and is most commonly associated with atrioventricular dissociation.

from: online-medical-dictionary.org

ERSlave : Maybe you are thinking of SVT as sustained v tach. It's not reallly a seperate thing, just a description. Like rapid a-fib. I would think it could be considered sustained if it lasted a few minutes. Hopefully someone would shock it before it went on too long!! Hope that helps!

aaaahhhhhh! sustained VT, not supraventricular tachy. In order to be "sustained" it has to last 30 seconds or more. Here's a reference:

http://www.merck.com/mmhe/sec03/ch027/ch027g.html

Be careful w/ the SVT acronym. As far as I know, it is used exclusively for SupraVentricular Tachy, but I could be wrong.

Supraventricular Tachycardia

A generic expression for any tachycardia that originates above the BUNDLE OF HIS.

Ventricular Tachycardia

An abnormally rapid ventricular rhythm with wide QRS complexes, usually in excess of 150 per minute. It is generated within the ventricle, below the BUNDLE OF HIS, and is most commonly associated with atrioventricular dissociation.

from: online-medical-dictionary.org

Got ya. I meant ventricular tachycardia. The MD (resident) wrote sustained v-tach. Thanks

A "run" would be 6 in a row or more. Sustained would be up to the persons opinion. How long do we wait before we call it sustained? 30 seconds? I'd say 30 seconds and I'd be running for the crash cart.

A "run" would be 6 in a row or more. Sustained would be up to the persons opinion. How long do we wait before we call it sustained? 30 seconds? I'd say 30 seconds and I'd be running for the crash cart.

I'd say anyone showing runs of Vtach would need a code cart, I personally wouldn't be waiting for 30 seconds of vtach before bringing it over...even if just to have lidocaine there immediately if not for cardioversion/defib.

Three beats of VT is considered pathologic, and over 30 seconds is considered sustained. Some people may have sustained VT and be alert, oriented, and conscious. Typically, they c/o dizziness, lightheadedness, palpitations, shortness of breath, or fainting.

In a case like that, you'd probably want to try some lidocaine or amiodarone to provoke the heart into NSR, but if that didn't work quickly enough, you might have to shock the patient, who hopefully has passed out by then.

P.S. Oh, and DO bring that code cart! Better to be safe than sorry.

before I started looking at a clock I would be looking at the pt. pulseless vs pulse. no pulse = electricity (ASAP), pulse=further eval, trial of meds, etc