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martes, 21 de enero de 2014


Prehospital Wisdom
In Prehospital Wisdom - October 29, 2013 - By Bill Johnston
..."Adenosine can actually be pretty dangerous in some settings. It can cause bronchospasm to the point of causing fairly severe problems, but the biggest problem comes when it is given to atrial fibrillation and atrial flutter. Atrial flutter with 2:1 conduction can often mask the pathognomonic sawtooth pattern and be mistaken for SVT. Administration of adenosine can cause the 2:1 flutter to accelerate to 1:1 flutter"..."Atrial fibrillation is something to be avoided, as well. First, adenosine plum doesn’t work to convert AFib. It works by slowing or blocking conduction through the AV node, but doesn’t work on bypass tracts like a Bundle of Kent. So adenosine can be especially dangerous if they have a bypass tract (which can be concealed). You may not see the nice textbook-style delta wave on a 12-lead. Adenosine can accelerate the rate to greater than 250 beats per minute, with subsequent hemodynamic instability. Ventricular fibrillation can even occur."