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falcon-18
03-12-2009, 02:46 PM
Hi, all

there is one female in ER she is chief complaint from chest pain when we put her on monitor, SVT rhythm, narrow QRS, B/P-130/85 HR 190 IV line is apparent and adenosin is ready but patient now altterd mental statues and B/P-65/35
and cool skin what you will do ? give adenosin or sync cardioversion ?
vquintessence
03-12-2009, 03:38 PM
zzzzzzzzzzzzzzzap. Hope you're not waiting by the pt for an answer :P
vquintessence
03-12-2009, 03:47 PM
^^^ based on the little info ya gave, but I'm curious... were vagal maneuvers tried during the 1-2 minutes getting the drug and bolus ready? A lot of ppl jump straight to Adenocard...

Seems like you're asking because they went ahead with Adenocard?
falcon-18
03-12-2009, 03:56 PM
yes i forget that vagal maneuvers done but no affect
firecoins
03-12-2009, 04:17 PM
well they had some affect. Look at the drop in BP. :)
falcon-18
03-13-2009, 01:29 AM
well they had some affect. Look at the drop in BP. :)

yes vagal maneuvers sometimes affected but to this pt not effect

BP-low cns-altterd skin cool all it is signs of unstable

but i want know when pt unstable and IV LINE is ready what we will do go to cardioversion or vagal maneuvers then adenosin
GonnaBeEMT
03-13-2009, 02:33 AM
If she is still in SVT and her bp went down like that I would say to do synched cardioversion
Silverstone
03-13-2009, 03:36 AM
Stable = Adenosine
Unstable = Synchronized Cardioversion

I'm sure you know how to differentiate between stable and unstable.
falcon-18
03-13-2009, 07:23 AM
Stable = Adenosine
Unstable = Synchronized Cardioversion

I'm sure you know how to differentiate between stable and unstable.

yes I know stable & unstable but pt come unstable after vagal maneuvers and

((IV LINE IS READY))

but- DR/ in ER said you must give adenosin becouse treatment of SVT is adenosin not
cardioversion but if IV LINE is not ready you will do cardioversion

((BUT I WILL DO cardioversion becouse adenosin contraindication when hyoptesion))

Who is agree me?
reaper
03-13-2009, 08:19 AM
What country are you in? What is your protocol there?
falcon-18
03-13-2009, 08:28 AM
What country are you in? What is your protocol there?

American Heart Guidelines
falcon-18
03-13-2009, 09:09 AM
this doctor is new
But he embarrassed when I asked him this question. Is a new staff member. he is Not expert
he is just now taking (ACLS COURSE)

dont warry about this question

close it

thanks every body

falcon-18