Physical Maneuvers to Break SVT

Getting a child/person out of SVT can be a bit tricky and unnerving sometimes.

Here is a list of the Physical Maneuvers we have tried and a few we have heard of but never done ourselves, I've listed them in order of safest to most dangerous. Also, I speak about babies in each maneuver but keep in mind all these maneuvers can successfully be used on any age.

1. Blowing air into the face. This works best on newborn babies but can also work on older babies/toddlers/children. Hold baby tight so she can't move her head away from the air flow, fill your lungs to full capacity and then blow forcefully (but slowly enough for yourself not to run out of air too quickly) directly into baby's face, directing the air flow mainly at the nose and mouth, blow until you are completely out of breath. The child will gasp and hold their breath unable to take in air for a second, this is what makes the heart skip a beat and hopefully restart (cardiovert) into a normal rhythm.

2. The gag reflex. Take a tongue depressor, or your finger if you don't have a depressor, put it on the very back of baby's tongue until you it their gag reflex. Sometimes gagging a baby for even just a second can make them panic and their heart will skip a beat making the heart cardiovert into normal rhythm.

3. Tip baby upside down. Safely hold your baby in your arms with the head fully supported and tip yourself and baby until baby is completely upside down, wait until baby's face starts to get a bit red then quickly bring back upright. This maneuver changes the blood pressure for just a minute thus hopefully cardioverting baby's heart back into normal rhythm.

4. Head between the knees. This one is more for older children/adults as it's kind of hard to get a baby or toddler to sit still in this position long enough. You place the head between the knees and push down causing pressure on the chest and heart. The pressure on the heart causes it to slow and hopefully force back into normal rhythm.

5. Bear down. You are causing the same effect as pushing to deliver a baby or pushing to have a bowel movement. For a baby you will lay baby down on the floor and place your hands around their knees, thumbs under the knees and fingers/hands around to the top. Gently roll baby's knees up to her chest and gently, but firmly, push. Your baby will grunt and possibly cry out, this is a sign that you are doing it correctly. Hold to the count of 5-10 seconds and gently release. The pressure causes the heart to slow and hopefully force it back into normal rhythm. For an older child/adult have them squat on the floor and push down as though trying to have a bowel movement or delivering a baby, count to 5-10 seconds and relax.

6.  Take a rectal temp, thus forcing baby to have a bowel movement and reset her heart rate.

7.  The Ball.  Roll her in as tight of a ball as you can get her and hold for 10 seconds.  Baby will cry, possibly scream, this means it's working.  This maneuver is quite similar to the "Bear down" method.

8.  Blowing into something.  Keep a long, skinny balloon on hand (like the balloon animal balloons), or even a medium-large sized syringe.  Have the child blow the balloon up, or blow into the syringe.  Some say having the child put their thumb in their mouth and blowing hard will also break SVT.

9.  A spritz of water to the face. Take a spray bottle, fill it with ice water, lay baby down on a safe surface and quickly spray her in the face, mostly around the nose and mouth, one quick spritz of ice water makes them gasp for air thus hopefully making the heart skip a beat and cardiovert back to normal rhythm.

10. Ice bag treatment. This one is not really a safe maneuver to do any time anywhere, I don't even believe a hospital should do it if it isn't absolutely necessary. At home, take a bag of crushed ice or small frozen vegetables (I much prefer a bag of frozen peas because they are round and not sharp or too bumpy).
     Option #1 (safest): Lay baby down on a safe surface, hold the bag with both hands, one hand on each side, and gently place the bag of ice (peas) over the forehead and bridge of baby's nose (not her whole nose, just the bridge) and hold for 3-5 seconds then release immediately. Quickly pick baby up and calm her, warming her head on your chest/shoulder. If baby doesn't calm down quickly her heart rate is likely to go right back into SVT.
     Option #2: Lay baby down on a safe surface, hold the bag with both hands, one on each side, and gently place the bag of ice (peas) over the forehead and cover the whole nose, hold for 3-5 seconds then release immediately. Quickly pick baby up and calm her, warming her head on your chest/shoulder. If baby doesn't calm down quickly her heart rate is likely to go right back into SVT.
     Option #3 (very much not recommended by me in any situation!!): Lay baby down on a safe surface, hold the bag with both hands, one on each side, and gently place the bag of ice (peas) over the nose and mouth, hold for 3-5 seconds then release immediately. Quickly pick baby up and calm her, warming her head on your chest/shoulder. If baby doesn't calm down quickly her heart rate is likely to go right back into SVT. This maneuver can potentially suffocate and cause your child to quit breathing, this in turn can cause brain damage or death, especially if the ice is left over the mouth and nose for more than 3-5 seconds. If you choose to try this maneuver PLEASE be careful! Remember 3-5 seconds only!

11. Ice bath. I have heard of hospitals/doctors using this one mostly over seas, not many times have I heard of it used here in the United States. It really is quite unnecessary in my opinion, very mean and very, very dangerous. I hate even mentioning it but since it is listed as one of the recommended physical maneuvers to cardiovert out of SVT I will list it, but I list it more as a warning NOT to use it than a recommendation of something that will work. Fill a large bowl with ice and water and dunk baby's face and head directly into the bowl pulling baby out immediately with no hesitation, bring baby directly to a towel to dry off and sooth and calm immediately. Remember, IF you choose to try this maneuver you ARE practically drowning your child, ANY hesitation while baby is under water can potentially cause death or serious brain injury! Remember, dunk in and right back out NO HESITATION!