Outstanding video and thanks for the evidence based practice. I was taught the 20cc syringe method in the 90's, and it's really nice to see that this was studied. Thanks!
I’m really glad you don’t teach the bearing down method considering how much more effective and better efficacy associated with blowing out of a syringe and laying down your patient as you demonstrated.
There is a great video of an actual case using REVERT trial method with conversion see the link below www.reddit.com/r/medicalschool/comments/dxwo97/modified_valsalva_maneuver_for_svt_clinical/
Certainly, first draw up 4ml or 12mg of adenosine in a 20ml syringe and fill the remainder 16ml with saline. I would not go to a 40ml of saline flush as that volume would not allow 1-2 sec of rapid administration of the drug.
thanks for the video. Question of back flow using the 3 way. what are the chance fluid back flow into the line distal to the proximal port when the you dont have handed to pinch the line
When administering medication to the patient with 3 way stopcock, the longer (off) cock bar should be turned off toward the main line (your IV fluids) that leaves only path from your medication towards the patient. Thus no need to pinch off the main line, there will not be any back flow. You can test it our for yourself, get an IV Bag, 3 way, and IV Admin set and a Saline lock.
Wouldn’t using the same needle you used to draw up medication with to draw up fluids mix adenosine into the IV bag? Or is it so minimal it wouldn’t matter?
One of the best teacher of his department
Thanks, Nikolay. You're a great instructor! I'm two years late on viewing this, but it still is great information and thank you for sharing!
I appreciate that!
Outstanding video and thanks for the evidence based practice. I was taught the 20cc syringe method in the 90's, and it's really nice to see that this was studied. Thanks!
Thank you, the single syringe method was very effective from my personal experience as well.
I’m really glad you don’t teach the bearing down method considering how much more effective and better efficacy associated with blowing out of a syringe and laying down your patient as you demonstrated.
There is a great video of an actual case using REVERT trial method with conversion see the link below
www.reddit.com/r/medicalschool/comments/dxwo97/modified_valsalva_maneuver_for_svt_clinical/
@@criticalcareift I’ve actually seen that video before. Thank you for all you do!
Can the single syringe technic be applied with 12mg adenosine and 20ml saline? or will you need 40ml of saline?
Certainly, first draw up 4ml or 12mg of adenosine in a 20ml syringe and fill the remainder 16ml with saline. I would not go to a 40ml of saline flush as that volume would not allow 1-2 sec of rapid administration of the drug.
thanks for the video. Question of back flow using the 3 way. what are the chance fluid back flow into the line distal to the proximal port when the you dont have handed to pinch the line
When administering medication to the patient with 3 way stopcock, the longer (off) cock bar should be turned off toward the main line (your IV fluids) that leaves only path from your medication towards the patient. Thus no need to pinch off the main line, there will not be any back flow. You can test it our for yourself, get an IV Bag, 3 way, and IV Admin set and a Saline lock.
Wouldn’t using the same needle you used to draw up medication with to draw up fluids mix adenosine into the IV bag? Or is it so minimal it wouldn’t matter?
It would be negligible, you can always exchange the needle if you are still concerned.
Yes sir! The single syringe system is the best way. I find the stopcock method too cumbersome.
Agreed!