Looking at the original work, adenosine was usually given via central line,
so a lower dose would be needed. I seem to remember Professor Chamberlain
(at a BASICs conference in the mid 90s- Glasgow or Manchester, I think-
someone else must have been there and can maybe confirm this) saying that
he'd step up the dose well beyond the Resus council guidelines (to which, of
course, he was a major contributor). However, I've never seen anything
published on this. (I've stopped doing it myself to save clinical governance
criticism rather than from any belief that it is dangerous).
In answer to Mandar Marathe's question, vagal manoeuvres do work in A and E
fairly often (interesting point- in my experience, carotid sinus massage
seems to work a lot better with the left rather than the right carotid. Is
this the case, is there any physiological reason why it should be the case
or am I just wrong?).
Matt Dunn
Warwick
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