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Cardiac - Carotid Sinus Massage

Clinical Indications: &= nbsp; &nbs= p; &= nbsp; &nbs= p;

= ______ 1. Trea= tment of supraventricular tachycardic dysrhythmias.

Procedure:

= ______ 1.      Oxyg= en, ECG monitoring, and IV therapy must be established before performing carotid sinus massage. Emergency medications and equipment should be immediately available.

= ______ 2.      Reco= rd the ECG rhythm continuously while performing all vagal maneuvers.

= ______ 3.      Try Valsalva’s maneuver first if the patient is able to cooperate. <= /o:p>

= ______ 4.      Gent= ly palpate both carotid arteries separately to assess the qualit= y of the carotid pulses. Auscultat= e both carotid arteries for the presence of bruits. If the pulses are grossly unequal, consult with medical control before performing the procedure.   If a bruit is detected, use = the opposite artery (if bruit free) for this procedure.

= ______ 5.      Loca= te the carotid pulse near the angle of the jaw using the flat side or your two fin= gers and press firmly against the carotid artery toward the cervical vertebrae.<= o:p>

= ______ 6.      Mass= age the area using a circular or vertical motion until the heart rate starts to slow or for a maximum of 1-2 minutes. Never massage both carotid arteries at the same time.<= o:p>

= ______ 7.      Cont= inuously monitor the ECG rhythm visually.

= ______ 8.      If unsuccessful, administer an appropriate pharmacological agent, and if neces= sary repeat carotid sinus massage on the same side.

= ______ 9.      The maximum number of attempts is three using the same side only.

= ______ 10. Docu= ment procedure and patient responses in the electronic PCR.

Certification Requirements:

Succ= essfully complete a biannual evaluation including the indications, contraindications, technique, and possible complications of the procedure.

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