What is the treatment for a "tet spell"?

The treatment for a "tet spell," which is a hypercyanotic episode commonly seen in patients with Tetralogy of Fallot, involves alleviating the right-to-left shunting of blood that results in decreased oxygenation and increased cyanosis. One of the most effective immediate interventions is to place the child in a knees-to-chest position, as this maneuver increases systemic vascular resistance and consequently encourages blood to flow from the systemic circulation into the pulmonary artery, effectively reducing the shunt.

In addition to positioning, administering 100% oxygen can also help improve the blood's oxygen content, providing some immediate relief from hypoxia. The high concentration of oxygen leads to vasodilation of pulmonary vasculature, further aiding in improving oxygenation.

While other interventions like administering IV fluids may have a supportive role in broader management, they are not the primary treatment for an acute tet spell. Immediate surgical intervention is often reserved for later management of the condition rather than in acute settings. Thus, the combination of the knees-to-chest position and oxygen administration directly addresses the physiological issues at hand during a tet spell.