2 references I found. The first states that Adensosine is
OK in the US (as FDA approved). Some concerns with
verapamil as it crosses the BBB.
The second states that you could always have given her
a fright!!.
AS regards vagal manourvres. There is quite a range of
quoted success rates for the termination of SVT's. Of
those in the A+E setting it seems to be between 7 and
30% if done properly (this can include putting the
patient head down).
I feel a BET coming on so I'm going to lie down until the
feeling goes away:-)
Simon
>My hesitation in using Adenosine in this lady was due
to the Manufacturer's Patient
>Information leaflet stating "Do not allow anyone to
give you this product if
>you are pregnant." My feeling was that the very short
half life, and the nature
>of this naturally occuring drug, meant that the drug
was safe, and my instinct
>was to give it. The mother was not haemodynamically
compromised by the SVT,
>so I had a bit of time to investigate further.
>The BNF lists no contra-indication for adenosine in
pregnancy, so having tried
>the full gambit of vagotonic tricks with no success we
persuaded the mother
>that adenosine was the first drug of choice with the
help of advice from the
>Guy's Hospital Reg. for Advice on Prescribing in
Pregnancy, and she cardioverted
>with 6mg. (Fetal ultrasound the next morning showed
a healthy baby.)
>
>Incidentally, I have twice placed patients in a supine
position to perform carotid
>sinus massage, only to find the change of position has
caused cardioversion.
>
>
>Marten Howes
>Sp Reg
>Preston
>
>
Simon Carley
SpR in Emergency Medicine
http://www.bestbets.org
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