Prehospital management of supraventricular tachycardia in Victoria, Australia: Epidemiology and effectiveness of therapies

Abstract

Patient characteristics associated with SVT are more likely to be middle-aged women with a history of hypertension and hypercholesterolaemia. Therapies were underutilised leading to reduced clinical guideline effectiveness. Where therapies were instigated, reversion rates are greater than previously reported.

Safety and efficacy of paramedic treatment of regular supraventricular tachycardia: a randomised controlled trial

“…Small prospective studies have demonstrated that administration of adenosine in a community setting is safe2 3 and there is a good correlation between paramedics' interpretation of the ECG and that of physicians 4 5. In cases where there has been inappropriate administration of adenosine, this had not been associated with adverse outcomes2 6 and, with training, inappropriate administration rates are reduced 7.…”

Measuring the effectiveness of a revised clinical practice guideline for the pre‐hospital management of supraventricular tachycardia

“…SVT was defined as a regular, narrow complex, tachycardia of ≥140 beats per minute, with a PR interval <0.08 s (or absent or retrograde p‐waves) . A previous study identified that Victorian paramedics were able to correctly interpret SVT on 3‐lead ECG, reporting correct identification of SVT in 119/123 (96.7%, 95% confidence interval [CI] 91.5–99.0) cases …”

“…16 A previous study identified that Victorian paramedics were able to correctly interpret SVT on 3-lead ECG, reporting correct identification of SVT in 119/123 (96.7%, 95% confidence interval [CI] 91.5-99.0) cases. 17 The primary study outcome was the proportion of patients in the pre-and post-intervention groups who reverted to sinus rhythm following paramedic management. Secondary outcomes were proportions of reversions following individual therapies (VM, pharmacological agents and Descriptive statistics were used to report demographic and patient-specific factors.…”

“…In Australia, the management of SVT by the eight State and Territory Ambulance Services varies considerably, from no active intervention to the use of vagal manoeuvres and pharmacological agents . The Victorian EMS system operates a two‐tiered system, with an ALS paramedic and mobile intensive care ambulance (MICA) paramedic designation.…”

“…In Australia, the management of SVT by the eight State and Territory Ambulance Services varies considerably, from no active intervention to the use of vagal manoeuvres and pharmacological agents. [16][17][18][19][20][21] The Victorian EMS system operates a two-tiered system, with an ALS paramedic and mobile intensive care ambulance (MICA) paramedic designation. For the past four decades, SVT management has been restricted to the MICA paramedics who were authorised to utilise a range of therapies and pharmacological agents.…”