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Does the new guide lines suggest giving Adenosine in stable VT to be
sure that the rythm is not SVT with bundle branch block?
Adenosine is primarily used to attempt to differentiate a couple of different types of rhythms. They are -
1. First and formost it helps to differentiate atrial flutter with 2:1 conduction from other tachycardias.
Atrial Flutter with 2:1 conduction is frequently mistaken for either sinus tachycardia due to flutter waves appearing like P waves. and they usually march out like p waves because the conduction time is so consistent. See attachment.
2. Any stable wide complex tachycardia that has a LBBB or RBBB morphology.
Regardless, Adenosine will slow AV node conduction and allow you to differentiate atrial activity more effectively.
adenosine will not effect a ventricular rhythm at all.
I have dealt with a handfull of patients where we used adenosine to unmask an underlying atrial rhythm. That is primarly what it is used to diagnosis.
Kind Regards,
Chris
If a pt does not have an advanced airway, do you stop compressions while delivering a breath, or do you continue compressions while delivering breaths?
Thanks,
Rhonda
If the pt. does not have an advanced airway, the 2 breaths are delivered after the 30 chest compressions. Once an airway is in place, the breaths are delivered at a rate of 1 ventilation every 6-8 seconds (8-10 breaths per minute and they do not have to be coordinated with the chest compressions. (see pg. 36 of the 2010 AHA Provider Manual)
Jeff