Welcome to episode 1 of The Ditch Doc EM Podcast!  In this episode, I’m going to share with you a technique that every single provider should know.  This technique just might save your patient from having to experience the “thrill” of adenosine.  You can listen on the embedded player, or, if you would prefer, click on the link below the player to listen on the Apple Podcasts app.

Listen to this episode on Apple Podcasts.

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Show Notes for Episode 1: Hold My Adenosine and Watch This!

Revert Trial

• Complete name: Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial
• “Standard” Valsalva was only effective in ~ 17% of patients w/SVT
• Valsalva + Postural Modification  = cardioversion out of SVT in ~ 43% of patients.

Link to the REVERT trial

How You Can Apply This Technique in the Field

1. ENSURE PATIENT IS STABLE!
2. Begin w/patient sitting in fowlers/semi-fowlers position
3. Provide patient w/10cc syringe & give instructions to blow into it for 15 seconds, in an attempt to blow the plunger out of the end.
4. Instruct patient to begin.
5. While timing for 15 sec, continuously coach patient, encouraging maximum effort.
6. At the conclusion of 15 sec, immediately lay patient supine and passively raise the patient’s legs to ~ 45 degrees.

 

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