Friday, July 23, 2010

Friday July 23, 2010

Q: Patient is in Supraventricular tachycardia (SVT). For the sake of discussion - name few vagal maneuvers (activation of the parasympathetic nervous system)?

Answer:


  • The Valsalva maneuver *1.
  • Just holding ones breath for a few seconds,
  • Coughing,
  • Putting towel of ice cold water on face(diving reflex)*2
  • Drinking a glass of ice cold water,
  • Standing on one's head!
  • Carotid sinus massage *3
  • Act of defecation or rectal massage
  • Act of urination

*1 The Valsalva maneuver works by increasing intra-thoracic pressure and affecting baro-receptors (pressure sensors) within the arch of the aorta.

*2 Diving reflex is triggered specifically by cold water contacting the face - less than 21 °C (70 °F). Submersion of body parts other than the face does not cause diving reflex. It cause bradycardia and peripheral vasoconstriction.

*3 Carotid sinus massage is often not recommended due to risks of stroke in those with plaque in the carotid arteries.

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