This doesn't make sense as raising the legs will increase venous return and according to the explanation, increase cardiac output (as per Starling's law anyway) with an increased heart rate. Not what you need to stop SVT!
Upping the ante a bit, has anyone seen VT responding to postural manouevres? We had one chap a couple of weeks ago with definite VT on ECG, became peri-arrest and therefore laid down in readiness for DCC then spontaneously went back to his usual AF, no BBB. Sat him up again and he reverted to VT after a couple of minutes. Laid him down again and he went back to AF. Gave strict instructions to keep him lying down until he got to CCU! There is some literature out there suggesting there are parasympathetic receptors in ventricular tissue (previously thought not to be) and that vagal tone is increased in supine position, especially right lateral position. So I was going to try vagal manouevres in the right lateral position to see if this helps with non-chemical cardioversion rate.
Nam Tong
Consultant A&E King's Lynn
>There's a nice explanation at:
>
>http://www.madsci.org/posts/archives/sep2001/1001183951.Gb.r.html
>
>Andrew Frazer
>Nurse Consultant
>Accident & Emergency Department
>Newham Hospital
>0207 363 8597
>0207 476 4000 - bleep 012
>
>
>-----Original Message-----
>From: Accident and Emergency Academic List
>[mailto:[log in to unmask]] On Behalf Of Adrian Fogarty
>Sent: 27 September 2005 12:31
>To: [log in to unmask]
>Subject: Re: SVT and raised legs!
>
>And what, pray, is the Bainbridge reflex?
>
>----- Original Message -----
>From: "Paul Bailey" <[log in to unmask]>
>To: <[log in to unmask]>
>Sent: Tuesday, September 27, 2005 9:19 AM
>Subject: Re: SVT and raised legs!
>
>
>>I use the valsalva maneuver with some success in SVT
>>
>>
>>
>> Patients revert when you release the pressure, not when the pressure
>is
>> up.
>> That's when the venous return would increase....
>>
>>
>>
>> Paul Bailey
>>
>> In a wet Perth, Western Australia
>>
>> _____
>>
>> From: Accident and Emergency Academic List
>> [mailto:[log in to unmask]] On Behalf Of [log in to unmask]
>> Sent: Tuesday, 27 September 2005 3:50 PM
>> To: [log in to unmask]
>> Subject: Re: [ACAD-AE-MED] SVT and raised legs!
>>
>>
>>
>> Guys, Don't forget the Bainbridge reflex
>>
>>
>
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