Post-Operative SVT

Started by NOPAIN, December 06, 2005, 06:46:00 PM

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NOPAIN

Pt is a 34. y.o. G1P1 status post c-section for failure to progress. Received an uneventful spinal anesthetic and c-section proceeded uneventfully. EBL approximately 700cc with 500 hespan and 1500 LR given intraop. Other medications given included pitocin, ancef, and zofran. 15 minutes after sign out of patient to L&D nurse, anesthesia was called for HR 187.

1) What is the differential?
2) How do you evaluate tachycardia post op?
3) What are the treatments?

frontier

#1
hi,
   was it a narrow complex tachycardia or broad complex?rhythm was regular or irregular?it may be SVT OR VT.was preop ECG normal?if it was SVT it will be terminated by vagal maneuver or inj.adenosine 6 mg iv,if it doesn't respond to 6 mg,give 12 mg bolus.if it still doesn't respond think of other things like VT etc.use amiadarone iv or synchronised  cardioversion will be treatment of choice.if it is polymorhic VT give high energy unsynchronised cardioversion.if it was irregular narrow complex tachycardia,think of atrial fibrillation or  if regular narrow comlex it can be atrial flutter or MAT,use diltiazem or beta blockers if not contraindicated.always treat underlying cause like hypovolemia,hypoxia,hypo & hyperkalemia,hypoglycemia,hypothermia ,hydrogen ion acidosis etc