What do you do with tet spells?

Place infants with hypercyanotic spells in the knee-chest position and give oxygen; sometimes, opioids (morphine or fentanyl), volume expansion, sodium bicarbonate, beta-blockers (propranolol or esmolol), or phenylephrine may help.

Why do tet spells happen?

Tet Spells happen when blood flow to the lungs is decreased. Less blood to the lungs means that less oxygen is getting picked up in the blood. Blood with lots of oxygen is bright red, while blood with less oxygen is darker, and bluish in colour. The blood with less oxygen causes the skin to have a blue tinge to it.

Why does squatting help tet spells?

Squatting is a compensatory mechanism, of diagnostic significance, and highly typical of infants with tetralogy of Fallot. Squatting increases peripheral vascular resistance (PVR) and thus decreases the magnitude of the right-to-left shunt across the ventricular septal defect (VSD).

Is a Tet spell an emergency?

Tet spell is an episodic central cyanosis due to total occlusion of right ventricle outflow in a patient with a congenital heart disease, such as Tetralogy of Fallot (TOF). There are limited cases of patients who lived with untreated TOF until adulthood. Tet spell in an adult is rarely seen in an emergency department.

Why does feeding cause Tet spell?

Sometimes, babies who have tetralogy of Fallot will suddenly develop deep blue skin, nails and lips after crying or feeding, or when agitated. These episodes are called tet spells. Tet spells are caused by a rapid drop in the amount of oxygen in the blood.

Why is morphine spelled in Tet?

If these maneuvers are unsuccessful, the most common subsequent treatment is to administer morphine, which calms the patient, resolves the hyperpnea, nor- malizes the systemic venous return, and increases the partial pressure of oxygen in the blood.

Why do you give morphine for Tet spell?

If the hypercyanotic spell is ongoing give intravenous or intramuscular (if no cannula) morphine. This helps calm the child down, reduces tachypnea and decreases pulmonary vascular resistance.

Why does squatting increase blood flow to lungs?

The net effect of squatting is there is a transient or sustained (as long as child squats) increase in pulmonary blood flow and this is made possible by the relative reduction of right to left shunt as the aortic and systemic resistance is raised by this posture.

What does squatting do to blood flow?

BACKGROUND–Squatting produces a prompt increase in cardiac output and arterial blood pressure which is accompanied by an immediate decrease in heart rate and forearm vascular resistance.

How does a child relieve a Tet spell?

If your baby or child has tet spells, your child’s doctor will show you how to place your child in a knees-to-chest position. This adjusts the pressure and blood flow in their heart. If tet spells happen often, typically this means it is important for your child to have surgery soon.

Why is morphine used in tetralogy of Fallot?

Morphine has been recommended primarily as a sedative for the treatment of TOF patients with hypercyanotic spells. However, morphine causes significant vasodilation in both venous and arterial beds, resulting in significant reduction of cardiac preload and systemic vascular resistance.

What is a tet spell in babies?

Tet spells. Sometimes, babies who have tetralogy of Fallot will suddenly develop deep blue skin, nails and lips after crying or feeding, or when agitated. These episodes are called tet spells and are caused by a rapid drop in the amount of oxygen in the blood.

What are tet spells in tetralogy of Fallot?

Tet spells. Children with tetralogy of Fallot may develop “tet spells”. These are acute hypoxia spells, characterized by shortness of breath, cyanosis, agitation, and loss of consciousness.

What are the signs and symptoms of tet spells?

A ventricular septal defect (VSD), which is a hole between the two lower chambers of the heart. Pulmonary stenosis (PS), which is a narrowing at or beneath the pulmonary valve. Overriding aorta, in which the aorta lies directly above the VSD. Thickening of the right ventricular wall. Children having a TET spell may have several symptoms:

What time of day do tet spells occur?

TET spells may occur at any time. They happen most often after the child wakes in the morning or after a nap. They also may occur when the child is crying, feeding or after exercise. What causes a TET spell?