LEVEL: Paramedic

The patient MUST be attached to a cardiac monitor
and MUST have vascular access prior to performing the procedure

This procedure may be performed on any patient who is experiencing Supraventricular Tachycardia with adequate perfusion.


Key procedural considerations:
A. Approved methods include:
1.  Valsalva maneuver
2.  Head-down tilt with deep inspiration
3.  Activation of the "diving reflex" by facial immersion in ice water (unless ischemic heart disease is present)
4.  Carotid massage (only on patients under 40 years of age)

B. In infants and young children, the most effective vagal maneuver is the application of ice to the face. IV access is not mandatory prior to vagal maneuvers in children.