how do you give it? I have always worked with another rn (so they could add a fast flush in addition to the ns hanging wide open) and had the patient on the crash cart monitor. I like to have the doc at the bedside too.
Last night I saw someone give it for svt in a stable patient with a rate in the 180s with no fluids and all by himself. I came in when he yelled for help as her rate jumped to the 270s.
I am pretty conservative safety wise but it surprised me enough to wonder how others cardiovert (chemically). What do you do?
we push adenosine on patients as long as they have a monitor on......telemetry included.......we just tell someone to watch the monitor, and run a continuous strip. i never had to code a person following adenosine. actually hung a continuous adenosine gtt once.......learn something new everyday
what???? adenosine gtt??? you gotta be kidding me? how? why?
please enlighten me here because i can't wrap my brain around this?
The unit I work on a RN can administer it but the MD must be present. Usually the MD will administer it. We always have the crash cart at hand as well as the heartrate and rhythum being observed by the monitor tech. We had one patient who the MD just wanted the rate to be slowed enough so he could determine what rhythum this patient was actually in. It was pretty cool to watch.
Saline running wide open. I connect the Adenosine syringe on the lower port and a plain saline flush at the distal port on the IV tubing. Then I squirt the Adenosine at the lower port (with saline still running wide open) and follow simultaneously with rapid push of the saline flush at the distal port.
We use portable 12 lead machines to diagnose arrythmias, so we leave it hooked onto the patient (and thus try to capture and print strips at different points of the treatment plan). Depending on the pt and/or presenting symptoms, we'll also hook pt. onto bedside defibrillator/pacer.
Crash cart outside room with RSI kit regardless of pts. symptoms.
BrnEyedGirl, BSN, MSN, RN, APRN
1,236 Posts
what???? adenosine gtt??? you gotta be kidding me? how? why?
please enlighten me here because i can't wrap my brain around this?