Adenosine on stepdown unit - page 2

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... Read More

  1. by   biandok
    Are there set monitoring requirements after giving adenosine?? Do you have a written protocol?

    Quote from Renee_RN
    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.
  2. by   biandok
    Do you have a protocol? What are the monitoring requirements?

    Quote from batmik
    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.
  3. by   biandok
    Do you have a written protocol?? What are the monitoring requirements?

    Quote from Tweety
    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.
  4. by   Renee_RN
    Quote from biandok
    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
  5. by   noki74
    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.
  6. by   jmgrn65
    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