Medications & Cardioversion

The treatment of choice for symptomatic patients with a stable blood pressure is IV administration of adenosine. The advantage of this drug is that it is relatively safe, has limited side effects, and has a half life of 5 to 10 seconds.

Watch the monitor with us in the Emergency Room. Examine nurse's notes as patient is treated for PSVT in the ER!

Intravenous propranolol and verapamil are commonly used to terminate PSVT in adults, but are used with greater caution in the pediatric patient. These medications result in long-duration adrenergic and calcium-channel blockade causing cardiovascular collapse, profound bradycardia, and death in the younger child. IV verapamil or propranolol can be used for the acute treatment of PSVT IF:

For the patient who is hemodynamically compromised, synchronized cardioversion is the treatment of choice. Ideally, prior to cardioversion, patients should:

Obviously though, if the child is quickly decompensating, cardioversion should not be delayed while the above therapies are performed.

The initial dose for synchronized cardioversion is 0.5 joules/kg. If PSVT persists the dose is doubled.

Long term medical treatment of most patients with PSVT often includes digoxin (except in those children with Wolff-Parkinson-White syndrome)

For more information on digoxin administration to children, click here

When the nurse provides discharge education for the patient and family, a careful review of the precipitating factors of PSVT must occur.

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If a second dose of Adenosine is indicated, it is to be the same amount as the first dose.


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