Comparison of Adenosine Administration Utilizing a Single-Syringe Versus a Double-Syringe Method in a Simulated Pediatric Patient.

OBJECTIVES

The primary objective was to compare adenosine administration time with the single syringe (SS) versus double syringe (DS) method in a simulated pediatric emergency department (ED) patient. Secondary objectives were to compare preparation time, preparation errors, administration errors, and participant preference/perception.

METHODS

This was a prospective, randomized, crossover simulation study. Adenosine doses were prepared by a pharmacist and administered by a physician. The primary outcome was administration time. Secondary outcomes were preparation times, participant preference, pharmacist-rated ease of preparation, and physician-rated ease of administration.

RESULTS

Sixteen pharmacist-physician pairs were included. The SS method had a shorter administration time versus the DS method [SS, median (IQR): 13 (10 to 15.8) s versus DS, median (IQR): 26 (20.8 to 31.3) s, P <0.001; median difference (95% CI): -13 (-22.5 to -9) s]. There were no significant differences in preparation times or pharmacist-rated ease of administration between the SS and DS methods. The SS method had a higher physician-rated ease of administration and was preferred by 68.8% of study participants.

CONCLUSIONS

The SS method had a faster adenosine administration time versus the DS method in a simulation setting, while also having similar preparation time, preparation errors, and administration errors. The SS method was rated easier to administer and preferred by most participants. Further study is required, as this study is limited by its simulation design and lack of clinical outcomes.