Thank you for watching! Please hit the like button if you enjoyed the video lesson. Feel free to leave comments if you have questions or feedback. We will try to answer them as soon as possible. Watch the entire Megacode Series Playlist here: th-cam.com/play/PLJ5kKhwVxA5LWvUYUzhtZIAFDKFibCiZp.html Check out these other great lesson playlists from our Channel: 👉 Understanding and Interpreting ABGs: th-cam.com/play/PLJ5kKhwVxA5J9q3KXz-w5Er6itwzIriMw.html 👉 One Quick Question Series: th-cam.com/play/PLJ5kKhwVxA5JBIokh4ddyRWelvnXlRtcQ.html 👉 ECG Rhythm Review: th-cam.com/play/PLJ5kKhwVxA5LlDt9S-venJPYWNN7_TSEX.html Visit our website for 100% online certification courses in ACLS, PALS, NRP, BLS and more. We also offer free practice exams, flash cards, study guides and other free educational materials: 🌍 www.healthedsolutions.com
Thank you for your helpful videos. I am curious about the recommendation in this one to do carotid massage. I understood it is no longer recommended at all.
Hi Susyn - we got an answer for you from our lead instructor and one of our medical review board members. Here it is below: This is the official AHA recommendation from the 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia. I have found no revision to the recommendation in the 2020 updates. For acute conversion of SVT, vagal maneuvers, including Valsalva and carotid sinus massage, can be performed quickly and should be the first-line intervention to terminate SVT. These maneuvers should be performed with the patient in the supine position. Vagal maneuvers typically will not be effective if the rhythm does not involve the AV node as a requisite component of a reentrant circuit. There is no “gold standard” for proper Valsalva maneuver technique but, in general, the patient raises intrathoracic pressure by bearing down against a closed glottis for 10 to 30 seconds, equivalent to at least 30 mm Hg to 40 mm Hg.82,84 Carotid massage is performed after absence of bruit has been confirmed by auscultation, by applying steady pressure over the right or left carotid sinus for 5 to 10 seconds.83,84 Another vagal maneuver based on the classic diving reflex consists of applying an ice-cold, wet towel to the face85; in a laboratory setting, facial immersion in water at 10°C (50°F) has proved effective in terminating tachycardia, as well.86 One study involving 148 patients with SVT demonstrated that Valsalva was more successful than carotid sinus massage, and switching from 1 technique to the other resulted in an overall success rate of 27.7%.82 The practice of applying pressure to the eyeball is potentially dangerous and has been abandoned. From Mark Dzwonkiewicz FP-C, LI: Remember to treat the patient. NO AHA recommendation applies to every patient and are not law, they are recommendations designed to build a foundation of care. Every patient must be evaluated and treated accordingly. In general, I do not use carotid message as a therapy for treating SVT especially in the elderly patient that may have developed carotid plaque. However, let’s say I have a younger adult patient in svt with underlying respiratory issues that prevent them from holing their breath and bearing down - a steady carotid pressure may help. But have a syringe of Adenosine in your hand just in case! Remember, your patient may have more than one medical issue at play here. Treat the patient. Thank you for the excellent question. Best, Mark Dzwonkiewicz
I really enjoy the Megacode series. I'm a landscaper, so I do jack shit related to the heart/ACLS, but I love guessing how these play out and how to treat the patients.
![BOWKYLION - วิงวอน (ex-change) [Official MV]](http://i.ytimg.com/vi/cLdnZWDaO-w/mqdefault.jpg)
Thank you for watching! Please hit the like button if you enjoyed the video lesson. Feel free to leave comments if you have questions or feedback. We will try to answer them as soon as possible.
Watch the entire Megacode Series Playlist here:
th-cam.com/play/PLJ5kKhwVxA5LWvUYUzhtZIAFDKFibCiZp.html
Check out these other great lesson playlists from our Channel:
👉 Understanding and Interpreting ABGs: th-cam.com/play/PLJ5kKhwVxA5J9q3KXz-w5Er6itwzIriMw.html
👉 One Quick Question Series: th-cam.com/play/PLJ5kKhwVxA5JBIokh4ddyRWelvnXlRtcQ.html
👉 ECG Rhythm Review: th-cam.com/play/PLJ5kKhwVxA5LlDt9S-venJPYWNN7_TSEX.html
Visit our website for 100% online certification courses in ACLS, PALS, NRP, BLS and more. We also offer free practice exams, flash cards, study guides and other free educational materials:
🌍 www.healthedsolutions.com
Thank u for posting this. Very helpful and solidifies the concept. Hope u can post more videos like this in the series. Once again, much appreciated.
Thank you for the awesome feedback! We are going to be releasing many more of these megacode simulators soon!
Many thanks for your clear and comprehensive video
Megacode series 👍👍👍👍👍👍 Keep continuing it 👍👍👍👍
Great example and very well explained! Thank you
Glad it was helpful!
Great VDOs!
Plzz keep continue to do this kind of videos
Thanks Kumar! Please subscribe and turn on your notifications because we have many more megacodes coming out:)
very helpful..thank you so much
Very good presentation
Very Helpful
Thank you so much for these! So helpful!
You're so welcome! Happy to hear you found the megacode scenario helpful! We will be releasing many more in the near future :)
Thank you for your helpful videos. I am curious about the recommendation in this one to do carotid massage. I understood it is no longer recommended at all.
Thank you for your question! We are glad the videos are helpful. We’ve passed along your question to the Health Ed Solutions medical review team.
Hi Susyn - we got an answer for you from our lead instructor and one of our medical review board members. Here it is below:
This is the official AHA recommendation from the 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia.
I have found no revision to the recommendation in the 2020 updates.
For acute conversion of SVT, vagal maneuvers, including Valsalva and carotid sinus massage, can be performed quickly and should be the first-line intervention to terminate SVT. These maneuvers should be performed with the patient in the supine position. Vagal maneuvers typically will not be effective if the rhythm does not involve the AV node as a requisite component of a reentrant circuit. There is no “gold standard” for proper Valsalva maneuver technique but, in general, the patient raises intrathoracic pressure by bearing down against a closed glottis for 10 to 30 seconds, equivalent to at least 30 mm Hg to 40 mm Hg.82,84 Carotid massage is performed after absence of bruit has been confirmed by auscultation, by applying steady pressure over the right or left carotid sinus for 5 to 10 seconds.83,84 Another vagal maneuver based on the classic diving reflex consists of applying an ice-cold, wet towel to the face85; in a laboratory setting, facial immersion in water at 10°C (50°F) has proved effective in terminating tachycardia, as well.86 One study involving 148 patients with SVT demonstrated that Valsalva was more successful than carotid sinus massage, and switching from 1 technique to the other resulted in an overall success rate of 27.7%.82 The practice of applying pressure to the eyeball is potentially dangerous and has been abandoned.
From Mark Dzwonkiewicz FP-C, LI: Remember to treat the patient. NO AHA recommendation applies to every patient and are not law, they are recommendations designed to build a foundation of care. Every patient must be evaluated and treated accordingly.
In general, I do not use carotid message as a therapy for treating SVT especially in the elderly patient that may have developed carotid plaque.
However, let’s say I have a younger adult patient in svt with underlying respiratory issues that prevent them from holing their breath and bearing down - a steady carotid pressure may help.
But have a syringe of Adenosine in your hand just in case!
Remember, your patient may have more than one medical issue at play here. Treat the patient.
Thank you for the excellent question.
Best, Mark Dzwonkiewicz
👍👍👍👍👍👍appreciation. Thanks for sharing your valuable knowledge information experience 🍀🍀🌸🌸🌹💛💛🌿🌿🥰🥰🥰🥰☘️
excellent and found it immensly useful..love from india
Thanks so much! Much love back at you!
helpful. thank you.
Thank you this is very helpful
Thank you so much!
You're welcome! Thank you for watching! More megacodes to come..
Thanks mam
The very first scenario is that the patient is pale, weak, tachypnea, and 180hr. That is symptomatic...what else do you want?
Thanks Michael for your thoughts
Yeah I was thinking that too, poor circulation just based on skin presentation. This is still a great video.
@OutcastBrAtZ-Clips Thanks for the kind words! Follow and turn on notifications as we will be releasing many more!
Unstable SVT is : chest pain, SOB, hypotension or confusion.
@@mohammadsalahuddin7269 thanks 🙏🏼
Perfect.. Thannks a lot
Carotid massage is not part of the ACLS anymore
Super
ACLS certificate helpful in India?
Gracias!!!
Thanks for watching Jimena!
Adenosine 6mg IV push .
I really enjoy the Megacode series.
I'm a landscaper, so I do jack shit related to the heart/ACLS, but I love guessing how these play out and how to treat the patients.
Great videos! Do you have updated mega code scenarios with 2020 guidelines?
Pals megacode
I would still give O2 to the patient…oxygen consumption goes up with increased myocardial workload…
Order Adenosine IV , if caratoid massage does not help.
Why will you teach Carotid massage?
Its dangerous
Jackson Elizabeth Allen Melissa Thompson Sarah
Hello
Megacode series only has NRP megacode scenario 1; & rest is ACLS & PALS. I only want NRP..... Why is this so difficult for you to understand
you are not helping me