Indications:
Paroxysmal and non-paroxysmal supraventricular tachycardia (SVT). Standing order administration for stable adults only, BioTel must authorize administration in unstable adults and in the pediatric patient.
Contraindications:
Precautions:
- Assure rhythm is not ventricular in origin
- Explain expected side effects to patient
- Monitor patient and ECG continuously before, during and after treatment
- Use with caution: COPD, CHF, CAD
Contact BioTel prior to administration for any of the following:
- Asthma patient taking bronchodilators (theophylline class)
- Seizure patient taking carbamazepine (Tegretol®)
- Recent caffeine ingestion
Side Effects:
Adult Dose:
Standing order:
- 12 mg rapid push followed immediately by a rapid 20 mL NS flush.
- If no conversion within 1 to 2 minutes, repeat the dose once, with a flush.
Pediatric Dose:
BIOTEL AUTHORIZATION REQUIRED
For Stable, Narrow-Complex Tachycardia (Probable SVT – HR greater than 220 in infant under 1 year old, or greater than 180 for child 1 to 8 years old; history; absence of P waves on ECG; no respiratory variation.)
- 0.1 mg/kg RAPID push/IO (maximum 6 mg) followed immediately by a RAPID 5-10 mL NS flush.
- If no conversion within 1 to 2 minutes, administer 0.2 mg/kg RAPID IV push/IO (maximum 12 mg) followed immediately by a rapid 5-10 mL NS flush.
For Stable Wide-Complex Tachycardia, the dose is the same.
For Unstable Tachycardia (Narrow- or Wide-Complex), the dose is the same; paramedics may prepare for immediate administration to the unstable child, but the dose should be confirmed by BioTel prior to administration
Route:
- IV, RAPID push at the insertion site (antecubital space); 2-syringe technique preferable.
- IO, RAPID push (alternative site); 2-syringe technique preferable.
Class: Atrial Antiarrhythmic
Onset: Immediate
Duration: 10 Seconds
Special: Record continuous ECG rhythm strip during administration