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J Korean Soc Emerg Med > Volume 26(6); 2015 > Article
Journal of The Korean Society of Emergency Medicine 2015;26(6): 571-576.
응급실에 내원한 발작심실상성빈맥 환자에서 투약 방법 교육에 따른 아데노신의 효과
황철민, 김정윤, 최성혁, 윤영훈, 박성준
고려대학교 의과대학 응급의학교실
Effects of Adenosine after Instruction of Injection in Patients with Paroxysmal Supraventricular Tachycardia Presented to the Emergency Department
Chul-Min Hwang, Jung-Youn Kim, Sung-Hyuk Choi, Young-Hoon Yoon, Sung-Joon Park
Department of Emergency Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
Correspondence  Jung-Youn Kim ,Tel: 02) 2626-1561, Fax: 02) 2626-1562, Email: yellowwizard@hanmail.net,
Received: June 30, 2015; Revised: July 2, 2015   Accepted: October 1, 2015.  Published online: December 30, 2015.
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.
Method:
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.
Key words: Adenosine, Emergency medical services, Supraventricular tachycardia
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