Recently patient was delivered to me in SVT 180 with blood pressure 75/45. Telephone order received for adenosine. Administered 6mg than 12mg to convert to sinus rhythm. Pushed hard; fast and flushed well. Watched the monitor.
Later Charge RN said I shouldn't have done this without MD at bedside. No protocol states I couldn't or outlined any details outside of ACLS. In review; I acknowledge recommendations of pacer pads, nearby crash cart, additional nurse RT in room.
I see the benefits in regards to a possible asystole pause. But I do not see where I was wrong in administration with doctors order.
Side notes: clinical setting ICU; acls provider (so I was familiar and comfortable with the drug). Again, no outlined protocol defining adenosine use and no restrictions in the Florida's nurse practice act.
