For pediatric stable SVT, which vagal maneuver is described?

For pediatric stable SVT, which vagal maneuver is described?

• A. Valsalva maneuver
• B. Bag of ice water on the face for 15 seconds
• C. Carotid sinus massage
• D. Ice pack on the head

Answer: (B)

This item tests recognizing an effective, safe vagal maneuver to terminate stable SVT in children. Cold facial immersion—placing a bag of ice water on the face for about 15 seconds—best fits this scenario. The cold stimulus activates the diving reflex, triggering increased parasympathetic (vagal) tone that slows conduction through the AV node, which can interrupt the SVT rhythm. While Valsalva can be used in older kids, it’s often less reliable and harder to perform in many pediatric patients. Carotid sinus massage is not appropriate in children due to risk and uncertain benefit. Simply placing an ice pack on the head does not reliably evoke the diving reflex and is not a standard vagal maneuver for this purpose.

This item tests recognizing an effective, safe vagal maneuver to terminate stable SVT in children. Cold facial immersion—placing a bag of ice water on the face for about 15 seconds—best fits this scenario. The cold stimulus activates the diving reflex, triggering increased parasympathetic (vagal) tone that slows conduction through the AV node, which can interrupt the SVT rhythm. While Valsalva can be used in older kids, it’s often less reliable and harder to perform in many pediatric patients. Carotid sinus massage is not appropriate in children due to risk and uncertain benefit. Simply placing an ice pack on the head does not reliably evoke the diving reflex and is not a standard vagal maneuver for this purpose.