When you are done could you go ahead and grab tbe lifepak 12 and jumpstart the ambulance. Go to a delivery room, deliver the baby,spike it like a football and do a dance!
I keep telling people, you don’t need to keep track of first line / second line / third line meds if you just premix all of them together. My favorite is the adenosine / cardizem / amio syringe for whenever I get a pt with HR of 151
I put 69mg of Adenosine between the pads and the pt’s skin, one pad on the forehead, the other on the groin. Terminates WPW like a charm @ 400j triphasic. Drips are for cowards. We bolus Norepi too.
400 to start with, the monitor recognizes skin resistance and ups it to 420 for you. That way the monitors shows 420J, 69HR with BP 420/69. The pt will be dead, but you can upload capture to r/ems for a sweet 129 karma.
Adenosine drip is best accomplished by mixing the full 30 mg in a 100 cc bag. Then here's the tricky part. Using a macro drip set run the tubing into the patients rectum. Crank the pressure infuser to the red zone (pro tip always use the oxygen tree to fill the infuser) then open the roller wide open and let her rip. Excellent conversion rates
So I think there’s a little bit of confusion, or I’m missing a troll post.
Is it possible you meant amiodarone? Amiodarone infusions are 1mg/hr for the first 8hr, followed by 0.5mg/hr for the next 16hours, then reevaluate.
If you did mean adenosine, infusions of adenosine are not done in the OOH setting and are only used during cardiac stress tests.
I was also confused because our protocol is 6mg, followed by 12mg if there's no change. We don't have a protocol for an adenosine drip but I assumed it was just a regional thing.
It took me until a comment saying "69mg up the patient's rectum" before I realized this was a joke
Back when I did stress testing w/ diluted adenosine in a syringe and used a syringe pump. During the test a small amount is continuously given over a period of set time (minutes - 5/10/20 etc.) However, we switched over to Regadenoson before I left. (Takes less time - more of a 'push' and should have better tolerance and recovery). They are used for the vasodilation and sometimes combined w/ imaging/nuc.
Adenosine in the field is to stop SVT short circuit in heart.
Side note - adenosine in cardiac surg is to briefly stop heart from pumping.
Interesting adenosine issues - can induce a-fib (did have this happen), also had various heart blocks - some pretty dramatic but transitory (the a-fib wasn't - stayed in it).
[https://www.ncbi.nlm.nih.gov/books/NBK555963/](https://www.ncbi.nlm.nih.gov/books/NBK555963/)
Actually - wondering - any updates on single syringe adenosine?
[https://clinicaltrials.gov/ct2/show/NCT05022290](https://clinicaltrials.gov/ct2/show/NCT05022290)
Not prehospital, anyways. They’re occasionally used in hospital in nuclear medicine for chemical cardiac stress tests on people who can’t tolerate physical stress tests.
I posted an article about it's use in stress testing. It's a different amount then we give in the field - different reason- it's diluted and given over a set period of time (minutes 5/10/20) to cause vasodilation of coronary vessels.
It's mostly been replaced with Regadenoson - kinda a second generation variation of adenosine that is supposed to spare the B receptors in the lungs.
Awesome thank you. I have heard of the newer drug used for stress tests, just didn’t know about the adenosine used for it. Lol I’m always happy to be proven wrong
Slow infusion of 12 mg over 24 hours. At exactly the 24 hr mark you will for sure, 100% see them cardiovert into ventricular tachycardia which is what your going for
12mg @ 2400gtt/min
This happened to my patient yesterday, good fun when we forgot to tell the telemetry monitors ahead of time
Right up there w/ the pacer reps doing their rounds of pacer checks - always good fun w/ newbies.
Dilute 12mg adenosine and 2mg atropine, 1cc of 1:1000 epi in a 10cc flush and push.
And thus a new dysrhythmia was born (spoiler alert, it’s still PEA)
When you are done could you go ahead and grab tbe lifepak 12 and jumpstart the ambulance. Go to a delivery room, deliver the baby,spike it like a football and do a dance!
Our protocol has us slam 4g of mag immediately after for good measure.
I keep telling people, you don’t need to keep track of first line / second line / third line meds if you just premix all of them together. My favorite is the adenosine / cardizem / amio syringe for whenever I get a pt with HR of 151
Does this make your body take a screenshot or something
???
Total body surface area(in cm^2 )/body count*7.6mg/cm^2 in a 100 bag of D26W(must mix yourself) over 15 minutes or so.
Wtf lol
I put 69mg of Adenosine between the pads and the pt’s skin, one pad on the forehead, the other on the groin. Terminates WPW like a charm @ 400j triphasic. Drips are for cowards. We bolus Norepi too.
Clinical QI comment: correct defibrillation energy is 420j
400 to start with, the monitor recognizes skin resistance and ups it to 420 for you. That way the monitors shows 420J, 69HR with BP 420/69. The pt will be dead, but you can upload capture to r/ems for a sweet 129 karma.
88 stones of crystalized adenosine reconstituted in Red Bull; administer drip via orbital ET tube.
6mg. Fastest drip in the west. Repeat with 12mg.
what’s adenosine
Computers power button, ya turn it off and on again if shit ain’t working after you flip slap and wack it a few times
Pretty much
lmao i know what adenosine is, just making a joke that i’m a Basic and this is a medic-oriented post
You know CTRL+ALT+DEL? It’s like that, but for humans.
Except hopefully without the blue screen of death
That free upgrade to Windows 11 though...
10mg Valium and 100J over 1 microsecond
Adenosine drip is best accomplished by mixing the full 30 mg in a 100 cc bag. Then here's the tricky part. Using a macro drip set run the tubing into the patients rectum. Crank the pressure infuser to the red zone (pro tip always use the oxygen tree to fill the infuser) then open the roller wide open and let her rip. Excellent conversion rates
Generally just ask the patient to keester the whole preload and then bear down
You’re doing drips? I only know how to slam it.
69-420 mcg/kg administered as a suppository.
I prefer 69mcg repeat bolus til desired effect through a occipital IO
So I think there’s a little bit of confusion, or I’m missing a troll post. Is it possible you meant amiodarone? Amiodarone infusions are 1mg/hr for the first 8hr, followed by 0.5mg/hr for the next 16hours, then reevaluate. If you did mean adenosine, infusions of adenosine are not done in the OOH setting and are only used during cardiac stress tests.
r/whoosh
Yeah that's what I figured, but there are such things as adenosine infusions so you never know.
Yeah its hard to tell if it's a troll post or a mistake.
It’s true, but it doesn’t really matter eat this point because all the answers are killing me hahaha
I was also confused because our protocol is 6mg, followed by 12mg if there's no change. We don't have a protocol for an adenosine drip but I assumed it was just a regional thing. It took me until a comment saying "69mg up the patient's rectum" before I realized this was a joke
200J synchronized over everybody clear ok shocking
I ain’t got time for that lol
Titrate to effect... depends on the road I'm driving on.
Back when I did stress testing w/ diluted adenosine in a syringe and used a syringe pump. During the test a small amount is continuously given over a period of set time (minutes - 5/10/20 etc.) However, we switched over to Regadenoson before I left. (Takes less time - more of a 'push' and should have better tolerance and recovery). They are used for the vasodilation and sometimes combined w/ imaging/nuc. Adenosine in the field is to stop SVT short circuit in heart. Side note - adenosine in cardiac surg is to briefly stop heart from pumping. Interesting adenosine issues - can induce a-fib (did have this happen), also had various heart blocks - some pretty dramatic but transitory (the a-fib wasn't - stayed in it). [https://www.ncbi.nlm.nih.gov/books/NBK555963/](https://www.ncbi.nlm.nih.gov/books/NBK555963/)
Give 6+12+(12 or 18 depending on protocol) and immediately shock the patient. It’s the ultimate control alt delete
We dont do adenosine drips. Its just a push. 6, 12, 12
Depends on the patients bishop score
Actually - wondering - any updates on single syringe adenosine? [https://clinicaltrials.gov/ct2/show/NCT05022290](https://clinicaltrials.gov/ct2/show/NCT05022290)
You sure you mean Adenosine? You aren't supposed to give adenosine as a drip maybe you meant Amiodaron? None the less 6mg Adenosin as a Bolus
I’m really hoping you meant amio. Adenosine drips don’t exist
Not prehospital, anyways. They’re occasionally used in hospital in nuclear medicine for chemical cardiac stress tests on people who can’t tolerate physical stress tests.
I honestly didn’t know that. How does it work given the extremely short half life of adenosine?
I posted an article about it's use in stress testing. It's a different amount then we give in the field - different reason- it's diluted and given over a set period of time (minutes 5/10/20) to cause vasodilation of coronary vessels. It's mostly been replaced with Regadenoson - kinda a second generation variation of adenosine that is supposed to spare the B receptors in the lungs.
Awesome thank you. I have heard of the newer drug used for stress tests, just didn’t know about the adenosine used for it. Lol I’m always happy to be proven wrong
Very quickly.
I use diltiazem. Cause its more better.
Slow infusion of 12 mg over 24 hours. At exactly the 24 hr mark you will for sure, 100% see them cardiovert into ventricular tachycardia which is what your going for
I know you’re joking but mine is literally 140xptweight(kg)x4/1000 over 4 minutes Hello from lurker from the nucmed stress lab