Three of my favorite letters in the Pediatric Emergency Department are S, V and T. This episode of PEM Currents, the Pediatric Emergency Medicine Podcast focus on the diagnosis and management of paroxysmal supraventricular tachycardia in the ED. I discuss preparation, vagal maneuvers, cardioversion, disposition and more!

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Appelboam, et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. The Lancet, 2015.

Friedman. Intraosseous adenosine for the termination of supraventricular tachycardia in an infant. Annals of EM, 1996

Garson et al. Supraventricular tachycardia in children: Clinical features, response to treatment, and long-term follow-up in 217 patients. The Journal of Pediatrics, 1981.

Getschman SJ et al. Intraosseous adenosine. As effective as peripheral or central venous administration? Arch Pediatr Adolesc Med. 1994 Jun;148(6):616-9.

Goodman et al. Intraosseous infusion is unreliable for adenosine delivery in the treatment of supraventricular tachycardia. Peds Emerg Care, 2012.

Hayes, Tricks of the Trade: Combine Adenosine with the Flush. Academic Life in Emergency Medicine, 2012. Accessed June 3, 2019.

Müller et al. “Vagal maneuvers” and adenosine for termination of atrioventricular reentrant tachycardia. The American Journal of Cardiology, 1994.

By bradsobo

Brad Sobolewski, MD, MEd is an Associate Professor of Pediatric Emergency Medicine and an Associate Director for the Pediatric Residency Training Program at Cincinnati Children's Hospital Medical Center. He is on Twitter @PEMTweets and authors the Pediatric Emergency Medicine site PEMBlog and produces and hosts the PEM Currents: The Pediatric Emergency Medicine Podcast.

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