V-tach

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Can someone give me or explain the rationale for instructing a client with unstable v-tach to inhale deeply and cough forcefully every 1 to 3 seconds during an episode of v-tach?

thanks in advance!

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Specializes in ICU/Critical Care.
Can someone give me or explain the rationale for instructing a client with unstable v-tach to inhale deeply and cough forcefully every 1 to 3 seconds during an episode of v-tach?

thanks in advance!

If the patient is unstable they need other means to correct their heart rate. Using vagal manuvers(sp?) would not be appropriate when the patient is unstable. They need defibrillation.

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Specializes in Cardiac Telemetry, ED.

Don't you mean paroxysmal supraventricular tachycardia?

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Specializes in Ortho, Case Management, blabla.
If the patient is unstable they need other means to correct their heart rate. Using vagal manuvers(sp?) would not be appropriate when the patient is unstable. They need defibriillation.

You're right about other means, but at the same time if the patient is conscious/breathing/has a pulse than the first thing to try would be vagal maneuvers.

A)They're cheap

B)They're faster than defibrillating

C)They don't hurt

D)It doesn't hurt to try

To the OP: Coughing is a "vagal maneuver" - stimulation of the vagus nerve, which can result in slowed conduction of electrical impulses through the atrioventricular (AV) node of the heart.

It's the same thing that causes people to have episodes of syncope when they're taking a dump...prolly what killed Elvis :bluecry1:

vagal maneuver is probably what they are looking for.

But If a patient is truely in unstable v-tach they probably wouldn't be conscious enough to cough...just sayin

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Specializes in ICU/Critical Care.

ACLS darling. Yes, if the patient was hemodynamically stable, you would use vagal manuvers first or treat the cause of the v-tach. But when the patient becomes hemodynamically unstable, vagal stimulation would be quite inappropriate.

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Specializes in Cardiac Telemetry, ED.

To the OP: Coughing is a "vagal maneuver" - stimulation of the vagus nerve, which can result in slowed conduction of electrical impulses through the atrioventricular (AV) node of the heart.

It's the same thing that causes people to have episodes of syncope when they're taking a dump...prolly what killed Elvis :bluecry1:

V Tach originates in the ventricles. Slowing conduction through the AV node has no effect.

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"A nurse is caring for a client with unstable v-tach. The nurse instructs the client to do which of the following, if prescribed, during an episode of v-tach?"

The choices are:

1. lie down flat in bed

2. remove any metal jewelry

3. breathe deeply, regularly, and easily

4. inhale deeply and cough forcefully every 1 to 3 seconds

The answer is 4. I want to know the rationale because it's not given.]

Thank you all for your responses.

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Specializes in Ortho, Case Management, blabla.
ACLS darling. Yes, if the patient was hemodynamically stable, you would use vagal manuvers first or treat the cause of the v-tach. But when the patient becomes hemodynamically unstable, vagal stimulation would be quite inappropriate.

yea yea yea I just took ACLS this weekend for the first time! that's why I put that little disclaimer at the bottom of my post

V Tach originates in the ventricles. Slowing conduction through the AV node has no effect.

Yea but it wouldn't hurt to try...miracles do happen. I've seen them :)

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Specializes in ICU/Critical Care.

Opps, sorry missed that last sentence. LOL. it's no biggie. Anyhow, yeah the patient would be too out of it to cough. Love the comment about Elvis croking while dumping..:yeah:

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Specializes in telemetry.

I think the rational would be that when take deep breaths and cough, the act of coughing creates pressure to enhance oxygen exchange. That this act could help hyper oxygenate the bloodstream and organs for before the Pt passes out. This would enhance Pt outcome until help/cardioversion can be delivered. I have heard this reccomendation before for an MI (alon with calling for help and ASA) and this was the rational given.

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Specializes in Cardiac Telemetry, ED.

It's a bad question. The Valsalva maneuver is indicated for PSVT. The patient with unstable V Tach would be given meds or synchronized cardioversion.

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Specializes in ICU/Critical Care.
It's a bad question. The Valsalva maneuver is indicated for PSVT. The patient with unstable V Tach would be given meds or synchronized cardioversion.

I agree. The question is bad.

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