I have always worked where nurses are available during stress tests. The nurse always administered the dobutamine (which I hate) and no we did not walk our patients, we did have them move their extremities to assist with heartrate elevation. We did walk our adenosine patients (never walked a LBBB) flat on a treadmill or just in place. Now, my facility where I work we are using lexiscan
and I love it (was using persantine up until 2 months ago!) 10 second IV push, flush then the radionuclide agent in 10 to 20 seconds. I see mostly complaints of upset stomach, headache, and shortness of breath. Smokers I see a cough almost everytime. Seems well tolerated by most patients including COPD. Have done a few asthma patient that are stable (not actively wheezing). I have used amino x 1 for ongoing chest discomfort with complete relief.
a good website to check out for information is http://lexiscan.com
. I still have my patients hold caffeine products for 24 hours before the test and encourage caffeine after the test is completed.
As the nurse in my facility, I am ACLS & the nuc tech (23 years experience) is ACLS. The nuc tech gives the lexiscan and follows with the radioisotope. Dobutamine I administer via a pump. I have alot of confidence in the nuc med tech I work with (he is also the RSO). Hope this information helps. ps...we rarely ever use dobutamine anymore!!