Adenosine for the prehospital treatment of paroxysmal supraventricular tachycardia

Annals of Emergency Medicine
M GauscheJ H Kuwate

Abstract

To determine the efficacy and feasibility of adenosine for the treatment of paroxysmal supraventricular tachycardia (PSVT) in the prehospital setting. Prospective case series. Large, urban, advanced life support emergency medical services system. One hundred twenty-nine adult patients with PSVT, as identified by paramedic personnel. Pregnant patients and those taking carbamazepine or dipyridamole were excluded. Dose of 12 mg adenosine by rapid i.v. push followed by a 5-mL saline flush and a repeat dose of 12 mg adenosine i.v. push if the patient's rhythm remained unchanged. Six-second lead II rhythm strips and vital signs were documented before and 2 minutes after the administration of adenosine. Demographic information, past medical history, medications, number of adenosine doses given, and complications were recorded by the paramedic on a case-report form. One hundred six of 129 (82%) of the case-report forms included the rhythm strips from before and after adenosine administration. Actual initial rhythms were determined by a consensus panel. The initial rhythms were PSVT in 79% (84 of 106) of patients, atrial fibrillation in 12% (13 of 106), sinus tachycardia in 5% (five of 106), atrial flutter in 2% (two of 106), and ventri...Continue Reading

References

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