In pediatric advanced life support, what is the recommended approach for managing stable paroxysmal supraventricular tachycardia?

The recommended approach for managing stable paroxysmal supraventricular tachycardia (SVT) in pediatric patients involves the administration of adenosine. Adenosine is an antiarrhythmic medication that effectively slows down conduction through the atrioventricular (AV) node, which can interrupt the reentrant pathways that are responsible for the SVT. This leads to a restoration of normal sinus rhythm.

The use of vagal maneuvers can be considered as an initial step for stable SVT management, particularly in young children, but the administration of adenosine is typically more effective and is a standard part of the treatment protocol. Immediate defibrillation is not appropriate in this situation because it is reserved for more life-threatening arrhythmias, such as ventricular fibrillation or pulseless ventricular tachycardia, rather than stable SVT. Continuous monitoring alone may not be sufficient, as active intervention is often required to terminate the arrhythmia and prevent potential complications. The focus in treating stable SVT is to relieve the tachycardia with effective interventions like adenosine, making it the recommended approach.