And I did say evidence....Best Bets only looks at a tiny proportion with
the search engine Medline which with a good quality searcher misses up
to 50% of evidence.
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Scott
Sent: 20 October 2003 21:58
To: [log in to unmask]
Subject: Re: SVT
Asthma as a contraindication?
See http://www.bestbets.org/cgi-bin/bets.pl?record=00112
Scott Taylor
----- Original Message -----
From: "Andy Webster" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, October 20, 2003 9:19 PM
Subject: Re: SVT
> If you only find 30% revert with adenosine, you are either not giving
> the right dosage in the right way, or giving the adenosine to patients
> without an SVT. The following is taken from the Prodigy website. A bit
> higher than 30% I suspect. Intravenous adenosine is now the drug of
> choice for terminating SVT. It has a rapid, short-lived action,
blocking
> conduction through the atrioventricular (AV) node, and is effective in
> virtually all cases of junctional tachycardia.
> Intraveous adenosine can also help diagnose an arrhythmia. If a
> tachycardia is halted, it is likely to have been junctional in origin.
> If there is transient AV block with specific ECG changes
(characteristic
> P waves, flutter, or fibrillation waves) the arrhythmia is likely to
be
> atrial tachycardia, flutter, or fibrillation. If adenosine has no
effect
> the arrhythmia is likely to be ventricular in origin [DTB, 1993; Chun
> and Sung, 1995; Ganz and Friedman, 1995; Li-Saw-Hee, 1998].
>
> As a side issue asthma is a contra-indication/or cautioned. Due to its
> short half life, it is probably still quite safe?is there much
evidence
> for catastrophy from using adenosine in asthmatics.
>
> Andy Webster
> A&E SPR, and fan of adenosine
>
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Rowley Cottingham
> Sent: 20 October 2003 21:01
> To: [log in to unmask]
> Subject: Re: SVT
>
> > Can anyone figure why Tony Blair needed a cardioversion i.e. DC
shock?
> > I've
> > only very rarely seen SVT not respond to adenosine, and on those
rare
> > occasions verapamil always worked.
> >
> > AF
> >
> >
> Not my experience at all. I only see about 30% revert with adenosine.
I
> tend to ask for
> cardioversion rather than verapamil as the next step.
>
> Best wishes,
>
>
> Rowley Cottingham
>
> [log in to unmask]
> Visit the new and improved http://www.emergencyunit.com
>
>
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