title: Valsalva using a syringe: pressure and variation.
abstract: BACKGROUND
  The Valsalva manoeuvre is commonly used in EDs to terminate supraventricular tachycardia by the patient blowing into a syringe.
  
  
  OBJECTIVE
  To identify whether a specific syringe size can be recommended for use in the ED.
  
  
  RESULTS
  20% of syringes 'stuck' and required high pressures to move. In the remaining 80% of syringes, a 20 mL syringe was the most appropriate size to achieve the recommended 40 mm Hg. Once 'released' plunger position did not make a difference.
  
  
  CONCLUSIONS
  Use of a syringe of any size cannot be recommended if a consistent pressure is required.
authors.affiliation: Emergency Medicine Academic Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
authors.forename: Hilary Sarah
authors.initials: HS
authors.lastname: Thornton
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
authors.forename: Mohammed H
authors.initials: MH
authors.lastname: Elwan
authors.affiliation: Emergency Medicine Academic Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Reynolds
authors.affiliation: Emergency Medicine Academic Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Coats
mesh_terms: D004636:Emergency Service, Hospital; D006801:Humans; D008365:Manometry; D011312:Pressure; D013594:Syringes; D013617:Tachycardia, Supraventricular / Q000628:therapy*; D014636:Valsalva Maneuver
keywords: arrythmia; emergency department; treatment