Effects of Adenosine after Instruction of Injection in Patients with Paroxysmal Supraventricular Tachycardia Presented to the Emergency Department.
- Author:
Chul Min HWANG
1
;
Jung Youn KIM
;
Sung Hyuk CHOI
;
Young Hoon YOON
;
Sung Joon PARK
Author Information
1. Department of Emergency Medicine, College of Medicine, Korea University, Seoul, Republic of Korea. yellowwizard@hanmail.net
- Publication Type:Original Article
- Keywords:
Adenosine;
Emergency medical services;
Supraventricular tachycardia
- MeSH:
Adenosine*;
Education;
Emergencies*;
Emergency Medical Services;
Emergency Service, Hospital*;
Heart;
Humans;
Medical Staff;
Retrospective Studies;
Tachycardia, Supraventricular*
- From:Journal of the Korean Society of Emergency Medicine
2015;26(6):571-576
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: There are many cases of paroxysmal supraventricular tachycardia (PSVT) presenting to the emergency department (ED) with palpitation as the presenting symptom. Adenosine is usually administered for conversion to normal sinus rhythm, with a possible second dose in the case of no response. As adenosine has a short acting time, administration of the drug at a vessel as close to the heart as possible is recommended, followed by an extra normal saline bolus infusion. In this study, we hypothesized a better outcome when adenosine was administered after proper injection method instruction was given to the medical staff. METHODS: We retrospectively studied the population of PSVT patients treated with adenosine. The cases were divided into two groups: one group consisted of cases a year before instruction for adenosine use became routine practice, and the second was comprised of cases a year after instruction protocols had been put into place. We further analyzed the proportion of patients who converted to normal sinus rhythm after a single dose of adenosine. RESULTS: All 306 patients were included. Before instruction, 46 patients (40.0% of 115) converted to normal sinus rhythm after the first dose. After instruction, 108 patients (56.5% of 191) converted to normal sinus rhythm after the first dose, which was statistically significant (p<0.05). CONCLUSION: After receiving proper education, more patients converted to normal sinus rhythm after the first dose. Instruction for proper adenosine injection technique for PSVT cases can increase the success rate of rhythm conversion on the first attempt.
