Unstable SVT in the ED

A 5 day old infant is brought to the emergency department with irritability, decreased oral intake, hypoactivity, and tachycardia. He was intubated for transport here. He has given adenosine twice for supraventricular tachycardia and now requires further intervention.

Learning Objectives

– Unstable SVT should be treated with cardioversion

– Scenario only resolves when learner performs cardioversion

– Once adenosine has been given twice correctly with no effect, it is of little utility to give additional doses

– Additional doses don’t advance simulation

– Fluid to optimize preload can temporarily stabilize a patient with an arrhythmia-associated hypotension