carotid sinus massage
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Carotid Sinus Massage
ca·rot·id si·nus mas·sage(kă-rot'id sī'nŭs mă-sahzh')
carotid sinus massageAbbreviation: CSM
CAUTION!CSM should not be performed on patients with known atherosclerosis of the carotid arteries, on patients who are elderly or of advanced middle age, or on patients with carotid bruits. Stroke may result from the procedure, esp. if small emboli break off from the carotid artery during the massage.
A patient with narrow complex tachycardia (QRS duration of less than 0.12 sec) is placed in a supine position and given supplementary oxygen. An intravenous catheter is inserted, and an automated blood pressure cuff is applied. Electrodes are placed on the chest to monitor heart rate and rhythm, and an oximeter is positioned on a finger or earlobe. The carotid arteries are examined for bruits. If any are present, the procedure should not be performed. The carotid sinus is located approximately 2 cm above the thyroid cartilage on the nondominant artery (usually the right carotid artery). Firm pressure is applied to the artery in a back and forth motion for about 5 seconds. The heart rate and rhythm are carefully observed during the procedure.