Modified Valsalva Manoeuvre

UNCONTROLLED WHEN PRINTED

Indications

To terminate SVT/narrow complex tachycardia by increasing intrathoracic pressure to stimulate vagal nerve response.

Contraindications

Patient Factors & Considerations

The following side effects might be experienced by the patient when performing the Valsalva Manoeuvre:
- Dizziness
- Hypotension
- Syncope
- Tinnitus
- Headache
If patient is on the stretcher, procedure is only to be performed while stretcher is locked into ambulance or lowered to ground height.

Procedure

All relevant infection control methods are to be utilised.
Prepare equipment required:
- 10mL syringe
- Oxygen tubing
- Sphygmomanometer
Explain the procedure to the patient.
Position patient in a semi-recumbent position.
Ensure ECG monitor is attached and all vitals are checked/monitored. Resuscitation equipment must be at hand as other arrhythmias may occur.
Consider IV access prior to performing procedure.

Patient position – Semi-recumbent
Connect the sphygmomanometer to the oxygen tubing.
Instruct the patient to take a deep breath in while placing the oxygen tubing in their mouth.
Instruct the patient to blow into the tubing and attempt to reach 40mmHg, maintaining pressure for 15-20 seconds.
Post procedure, patient’s head to be lowered into a supine position with the legs raised (where possible) approx. 45 degrees (Trendelenburg position) for 15 secs.
If unsuccessful in the first instance the procedure can be repeated once.
If a sphygmomanometer is unavailable another method is to instruct the patient to try and blow the plunger of a 10mL syringe until movement is just seen for 15-20 seconds.