Laughter is the best medicine: A novel finding in the treatment of supraventricular tachycardia in a paediatric emergency patient

We present a novel case of laughter induction that was noted to terminate an episode of supraventricular tachycardia (SVT) in a 10 year old girl who presented to a large metropolitan emergency department. In the initial management of this patient's SVT, traditional vagal maneuvers (including the valsalva maneuver and stimulation of the mammalian divers reflex) were attempted unsuccessfully. While awaiting further treatment, nursing staff presented the patient with an inflated examination glove that had been crafted into the shape of an elephant. This resulted in a fit of laughter that appeared to terminate the child's arrhythmia. Existing studies identified in the literature help to establish a correlation between the thoracic and cardiovascular physiology of laughter and the mechanics of the traditional Valsalva maneuver. Our patient's case highlights the potential positive impact of this physiology when applied in the context of the paediatric patient presenting in SVT. In the context of the available evidence, the case of our 10-year-old patient serves as a thought-provoking example of the real world relationship between laughter and the traditional Valsalva maneuver. The utility of laughter in the management of supraventricular tachycardia is an area that warrants further investigation. (C) 2019 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.