Effect of adenosine on the management of supraventricular tachycardia by urban paramedics.
Study Objective: To determine the effect of the addition of adenosine, as a standing-order medication, on the prehospital management of supraventricular tachycardia (SVT) in a large urban emergency medical services (EMS) system.Design: Prospective observational case series with historical controls.S...
| Publicado en: | Annals of Emergency Medicine Vol. 26; no. 6; pp. 691 - 697 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
1995 Dec
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107383849&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 107383849 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01960644 1WN jtl: Annals of Emergency Medicine issn: 01960644 maglogo: N pubinfo: dt: 1995 Dec vid: 26 iid: 6 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 107383849 107383849 NLM7492038 1996030672 10.1016/s0196-0644(95)70039-0 NLM7492038 107383849 ppf: 691 ppct: 6 formats: tig: atl: Effect of adenosine on the management of supraventricular tachycardia by urban paramedics. aug: au: Lozano M Jr. McIntosh BA Giordano LM Lozano, M Jr McIntosh, B A Giordano, L M affil: Section of Emergency Medicine, Bayfront Medical Center, St. Petersburg, Florida, USA sug: subj: Emergency Medical Services Evaluation Adenosine Therapeutic Use Tachycardia, Supraventricular Drug Therapy Prehospital Care Evaluation Prospective Studies Nonexperimental Studies Electrocardiography Convenience Sample Data Analysis, Statistical New York Data Analysis Software Database Management Software Child Adolescence Adult Middle Age Aged Aged, 80 and Over Male Female Human Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Study Objective: To determine the effect of the addition of adenosine, as a standing-order medication, on the prehospital management of supraventricular tachycardia (SVT) in a large urban emergency medical services (EMS) system.Design: Prospective observational case series with historical controls.Setting: Large urban municipal EMS system staffed by paramedics and emergency medical technicians trained to operate automatic or semiautomatic defibrillators (EMT-Ds).Participants: We observed a consecutive sample of prehospital patients who presented with an initial ECG rhythm of SVT, as interpreted by the treating paramedics, between July 1 and December 31, 1993. We used patients from the same 6-month period in 1992 as our control group. Indications for treatment were chest pain, evidence of myocardial ischemia, or shock. Adenosine had been introduced as a first-line medication to be used under standing orders in cases of unstable SVT before a physician was contacted for medical control options.Results: We studied 239 cases and 228 controls. Acceptable call reports with pretreatment and posttreatment ECGs were available for 140 (59%) of the study cases and 104 (46%) of the controls. The two groups were similar in terms of age, sex, and initial vital signs. In the control group, 75 patients had indications for treatment, and 16 were treated (21%). In the study group, 127 had indications for treatment and 103 (81.1%) were treated (odds ratio, 15.83; 95% confidence interval, 7.38-34.4).Conclusion: The introduction of adenosine as a standing-order medication into an urban EMS system increased the proportion of patients who received advanced life support treatment. Paramedics were able to accurately diagnose and begin treatment of SVT with adenosine without direct medical supervision. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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