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cardiology emergency-medicine

SVT Termination Score and Adenosine Dosing

Guides assessment and management of narrow complex tachycardia (SVT/AVNRT) including vagal manoeuvres and adenosine dosing by body weight.

Score interpretation

SVT terminated by vagal manoeuvres

→ Monitor; ECG post-termination; 12-lead ECG for delta waves (WPW); electrophysiology referral if recurrent; patient education on vagal manoeuvres

Haemodynamically stable SVT requiring adenosine

→ Adenosine: 6mg rapid IV bolus (large peripheral vein) + 20ml saline flush; if no response 2 min: 12mg; if no response: 12mg again; warn patient of transient chest tightness, flushing, dyspnoea; monitor ECG throughout; avoid in asthma (use verapamil instead)

Broad complex or haemodynamically unstable

→ Unstable: synchronised DC cardioversion 200J biphasic under sedation; broad complex SVT: amiodarone 300mg IV over 20-60 min; if VT suspected: seek cardiology urgently; do NOT give verapamil with broad complex

Interpretation bands for the SVT / Adenosine. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.