Which condition is an indication for vagal maneuvers?

• A. May be performed on any patient who is experiencing SVT with adequate perfusion
• B. Intractable ventricular tachycardia
• C. Acute myocardial infarction with ST elevation
• D. Pulseless VT

Answer: (A)

Vagal maneuvers are noninvasive techniques used to terminate a stable supraventricular tachycardia by increasing vagal tone and slowing conduction through the AV node. They are appropriate only when the patient is hemodynamically stable and has adequate perfusion, because a quick, safe chance to convert the rhythm relies on a pulse and good blood pressure.

This makes the statement that you may perform vagal maneuvers in any patient with SVT who is adequately perfused the best choice. They are not indicated for rhythms like ventricular tachycardia, especially if it is unstable or pulseless, and they’re not appropriate in the setting of acute myocardial infarction with ST elevation, where definitive ACLS interventions are needed.