This is EM cases, EM Quick Hits podcast, where our team of experts and educators bring

a clear, concise, and condensed, practice-changing knowledge on all those EM topics you

may not be totally comfortable with. Cases, the latest evidence, concise, and condensed practice-changing knowledge on all those EM topics you may not

be totally comfortable with. Cases, the latest evidence, procedural tips and tricks, pitfalls

to avoid, and the key take-home points and references on the EM cases website.

Quick. Let's get on with it.

First up, we've got a new addition to the EM Quick Hits.

The Best of Rebel EM with my friend

and fellow educator, the Rebel himself, Salim Rosey from San Antonio, Texas.

He's going to give us a quick hit on how best to administer adenosine for SVT.

But as he'll mention, and as I've mentioned a couple of times before on EM cases, my first

line medication in SVT is Diltaism. There's good evidence that it works just as well as adenosine, but without that terrible feeling of doom that patients get with adenosine. Take it away, Sal. Hey there. This is Salim Raziah, creator and founder of Rebel EM. This month, what I thought we would do is cover a paper that got

a ton of traction on the Rebel EM website. We can just call it the best of Rebel EM. And it was on

single syringe adenosine for superventricular tachycardia. Now, as a bit of background, the

2015 American Heart Association guidelines for adult advanced cardiac life support,

recommend adenosine and non-hypotensive patients in regular narrow complex, superventricular tachycardia, or SVT for short.

Now, the thing about adenosine is it has a rapid onset and a half-life that is less than 10

seconds.

This makes it an ideal agent for hemodynamicsly stable patients

in SVT because it's a quick-on, quick-off medication. But also on the other side of that,

because of the short half-life of adenosine, several advocate for a two-way stopcock, where

adenosine and a 10-20-ml saline flush are given in tandem.

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