Supraventricular tachycardia (SVT)

We had a lesson about ICU nursing and care for critically ill patient about two weeks ago. We got an assignment related to that lesson. We were supposed to to choose one type of heart arrhythmia and write about here in the blog. I chose supraventricular tachycardia (SVT). I didn't have any special reason why I chose SVT.
The Evidence-Based Medicine Guidelines (EBMG) define SVT:  "it is typically a narrow-complex regular arrhythmia with an abrupt onset and termination". SVT starts rapidly and lasts usually from minutes to hours. Structure which causes the arrhythmia is located in the atrium or somewhere between the atrium and ventricular of the heart. SVT causes pulsating feeling in the chest and low blood pressure because the minute volume of the heart decreases 40% from the normal during arrhythmia. Usually the drop in blood pressure is improved quickly back to normal because of the compensatory mechanisms used by the cardiovascular system. The drop in blood pressure causes symptoms like dizziness, nausea, vapour, blurring of the vision, decreased level of consciousness, pain or feeling of constriction in the chest. Need to urinate more often than usually can be linked into the attack also the person might be tired after the attack. Even though these attacks are mainly harmless minor of these attacks might be dangerous if they are prolonged.
The attack may occur when there is a combined effect of a trigger, right kind of circumstances, and a structure in the heart which causes arrhythmia. Extrasystoles are the most common triggers of tachycardia also moves (e.g. bending over, yawning, coughing,  be frightened, or after hard physical or mental stress)  which causes abrupt vagal nerve stimulation. The right kind of circumstances for the tachycardia may occur if the person is tired, stressed, has used great amounts of substances, has infectious disease etc. If the conduction pathway are unusual or the heart tissue has changed because of a disease the structure of the heart is more likely to cause arrhythmia.
Usually SVT stops by itself and they occur seldom. If SVTs starts to occur more often and the symptoms become more severe curative treatment (catheter ablation) and prophylactic treatment (drug therapy) should be considered. If the diagnosis has been made and the person tolerates the arrhythmia quite well the agal stimulation is the first-line treatment for a acute episode of SVT. If the vagal stimulation is ineffective the person should be given adenosine i.v.. If the tachycardia is very fast or the person doesn't tolerate the arrhythmia cardioversion might be needed.

I have used Terveysportti as a reference in this report.
http://www.terveysportti.fi.ezproxy.jamk.fi:2048/ebmg/ltk.koti
http://www.terveysportti.fi.ezproxy.jamk.fi:2048/dtk/oppi/koti?p_artikkeli=kar00059&p_haku=supraventricular%20tachycardia

Perioperative simulations

We had skill lab lessons last Wednesday and during those lessons we had perioperative simulations. We had  one case and from that case we had two different simulation practices. In the case we had an elderly lady with hip fracture and she was about to have a surgery so the simulation practices were about scrubbing and circulating, and anesthesia.
I was in a group which made first the circulating and scrubbing simulation. In that simulation we were supposed to get lady ready for operation. Half of the group was first did the circulating part and the other half did the scrubbing. I did first the circulating part so I was helping the scrub nurses with their sterile gowns and I also opened the sterile packages. The rest from the circulating group were washing the site of surgery. When we had got the patient ready for the operation we switched parts so in the second time I was in the scrubbing group.  At first we performed the hand wash and after that we put the sterile gowns and gloves. We we had all the sterile clothes on we did the sterile draping which means that we covered up the patient with sterile paper sheets so that only the operation side is showing.
The second simulation was about the anesthesia preparations before the surgery. At first we got the patient's background information and we were supposed to gather all the things needed in spinal anesthesia. We were working as a one group and we first made the list about the things we would need in this anesthesia. After we had made the list we gathered all the things from the anesthesia table. When we got all the things ready the anesthesiologist came and started the anesthesia. After the anesthesia was ready the patient got sick so we needed to give her some antiemetic drug. Her pulse was also quite low so we had to treat also that.
I didn't learn that much new things during those simulations since I have already been practicing in operation room but it was very nice and useful revise about all the things related to the surgery preparations.