Adenosine on stepdown unit

Specialties Cardiac

Published

I work on a cardiac stepdown unit in a large hospital. Traditionally we have not given adenosine without a physician present. Our physicians are wanting to put together a protocol that would allow the nurses the push adenosine without a physician. Is this acceptable practice in your institution? Does anyone have a protocol? Thanks

What is the nurse patient ratio for the stepdown patients?

During the day, 4:1

Night Shift 6:1

Since we are small, the cardiologists round in the AM and do not come back unless......well they don't come back. We have a dysrhythmia protocol that covers the major dysrhythmias but it is not uncommon to take a verbal order for adenosine, corvert, etc. I would love for more physician involvement, but the reality of the matter is us nurses continue to do these things for their convenience.

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Are there set monitoring requirements after giving adenosine?? Do you have a written protocol?

During the day, 4:1

Night Shift 6:1

Since we are small, the cardiologists round in the AM and do not come back unless......well they don't come back. We have a dysrhythmia protocol that covers the major dysrhythmias but it is not uncommon to take a verbal order for adenosine, corvert, etc. I would love for more physician involvement, but the reality of the matter is us nurses continue to do these things for their convenience.

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Do you have a protocol? What are the monitoring requirements?

I work on tele and it started with the MD having to give it, then MD having to be in the house and now we can just give it. I have never had to give it myself but have been around when another nurse has given it. Personally I think it is quite scary. We give it infrequently on my unit thankfully. But it does work well and quickly. Of course we are ACLS trained and have a monitor/defib/pacer at bedside.
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Do you have a written protocol?? What are the monitoring requirements?

I gave it in neuro step down, I was waiting on an ICU bed, which sometimes takes a while. Our cardiac step down gives it as well, because I've transferred patients there who have orders to give it. We don't have physicians present when we give it.
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Do you have a written protocol?? What are the monitoring requirements?

For specific dysrhythmias, we have a protocol (basic ACLS)

For meds such as adenosine and corvert, the pt is on a bedside monitor and nurse at bedside (If it gets ugly, call a code or pt transfers to ICU)

We always get pre/intra/post tele strips for charting purposes

For meds such as Natracor, Amiodarone, Cardizem- the pt has a bedside monitor that recycles BP's frequently

If a pt comes up on IV nitro or any pressor - if we have to titrate up the infusion, the pt (in theory) will go in the unit

There has been a few times on nights where I have had a unit pt with several stepdown pts because there were no beds available in the unit

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In may country even we are a ACLS trained nurses we aren't allow to give a adenosin without a presenc of the pschiciant, in a case of need we have to prepare for everything because it may go something wrong during a adenosin treament (MD.Monitoring and also ready to intubate) if is need.

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Specializes in cardiac/critical care/ informatics.

We give adenosine when it is required, the only medicine we don't give on our unit is covert, meds for dysrhtymias, knowing our facility eventually we will be giving it also, I am on a step down unit. And no specific protocol just acls :rolleyes:

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