Vagal Maneuvers for SVT ======================= Date sent: Fri, 23 May 1997 21:46:58 +1030 Send reply to: "EMED-L is a list for hospital based emergency medicine practitioners." From: Hugh Grantham Organization: South Australian Ambulance Service Subject: Re: What would you have done? To: Multiple recipients of list EMED-L Bob..... > Is that correct? Surely some of those out there with the MedLine connection > can confirm or correct this? > No not medline but that rare asset a book! Reference The diving women of Korea and Japan Hong and Rann Scientific American May 67 Documented a drop in pulse from 100 to 60 over a 40 sec dive. I'm sorry to tell you that they also noted that the drop was the same in winter and summer 50F and 80F respectivly. As you say thaat is not realy cold enough to work! We used to do this as a practicle with students but have rather gone off the idea since iced water produced one bradycardia <20 in about 10 sec! I dont know why we were intimidated as the student:- a) got quickly better and b) was replacable..:-) Hugh Bob Woolf wrote: > > In a message dated 97-05-20 11:32:16 EDT, you write: > > > > > If you are hesitant to use a CSM (I am without a scope!) or a valsalva, > > what about a cold washcloth on her face? > Jeff, > > It would have to be a VERY cold washcloth. If I remember correctly from the > articles I have read, the bradicardic reflex isn't triggered until you get > somewhere below 40-42 degrees F. Anything above that and all you have is > valsalva. The original article that brought this to everyone's attention, I > seem to recall, was in Scientific American sometime in the sixties or > seventies (1972?) and was done on the diving girls of Japan. Later work > showed that the trigger was getting the area around the eyes and nose (the > face) wet AND cold to 40 degrees or lower while doing valsalva. > > Is that correct? Surely some of those out there with the MedLine connection > can confirm or correct this? > > Back in my younger days (Hey, at this age that'a about all I have left!) when > I was more active and less intelligent (more or less!) I use to do a lot of > Cave Diving down in Florida in the fresh water springs. Yes, Elizabeth, the > crazy man would put on unbelievably heavy diving gear and go into underwater > caves for fun! > > Florida is hot and humid and after getting into those very warm neopreme wet > suits, strapping on double 80's or 90's or even 100's, the three light > systems, octypus regulators, BC, weight belts, etc., etc. (you get the idea) > and then climbing (usually) down a 20 or 30 foot rock face to reach the water > while wearing all of that, you would find yourself with a pretty high heart > rate. > > Since we wanted to make the most of our downtime and air supply we would try > to use the bradicardic reflex to slow our bodies down before submergine. > Don't know if it really helped in the long run or if it was just the time we > took to set there in the water at the surface and calm down and cool off, but > I noticed then that the 60 - 70 spring water never really kicked in on the HR > slowing like the ice baths back in the ER. > > Bob (Help! I'm lost in a cave and can't get out!) Woolf