Sinus Tachycardia Hurry, don’t let time run out! Sorry, time is up! 0 Hours 0 Minutes 0 Seconds Step 1 of 4 25% Untitled A 12-year-old female presents to the emergency department complaining of intermittent palpitations and fatigue. She denies any other associated symptoms. Initial vitals demonstrate the following: T: 36, P: 110, BP: 92/54, R: 14, O2: 100%. The monitor demonstrates the following: 1. What is your initial step in management?* Administer a beta-blocker or calcium channel blocker Administer adenosine Synchronized cardioversion Identify the underlying cause The patient suddenly reports feeling light-headed and is again experiencing palpitations. Repeat vitals: P: 160, BP: 92/54. You now see the following rhythm on the monitor: 2. What is your next step in management?* Identify the underlying cause Synchronized cardioversion Administration of adenosine 0.1mg/kg with maximum of 6mg dose Administer IVF’s 3. Which of the following describes appropriate vagal maneuvers that can be attempted to convert the patient back to normal sinus rhythm?* Cardiac thump Carotid massage or valsalva with leg lift Hot water immersion Shoulder massage After two doses of adenosine, the rhythm strip is unchanged, the patient remains in SVT. She now feels very light-headed, nauseated, diaphoretic and repeat vitals demonstrate the following: HR: 220, BP: 60/30, O2: 98%, RR: 24. 4. What is the next step in management?* Administer a beta-blocker Synchronized cardioversion at 0.5 J/kg Intubate Valsalva maneuvers
