Ep. 155 Deep Dive: Adenosine Dosing in SVT - Is 12 the New 6?

 

Welcome to the Prehospital Emergency Care Journal Podcast!

In this PEC Podcast Deep Dive, Rebecca Cash and Maia Dorsett interview Dr. Tony Fernandez
about his recent PEC paper comparing initial prehospital adenosine doses of 6 mg versus 12 mg
for presumed SVT. We explore the study’s origins, dataset design, and results—including the
finding that starting with 12 mg was associated with higher rates of cardioversion and fewer
redoses without an increase in complications. Along the way, we discuss the quirks of EMS data,
why some “standard” practices exist without strong evidence, and how retrospective studies fit
into the bigger picture of protocol change.

For those whose interest in study methods was piqued, here’s a great short primer on odds
ratios versus relative risk: https://www.youtube.com/watch?v=dWtzaKYFg00&t=175s

Featured Article

Fernandez, A. R., Bourn, S. S., Duncan, D., Slovis, C. M., Crowe, R. P., Treichel, A., & Myers, J. B. (2025). Comparing Prehospital Adenosine Initial Dosing of 6 mg Versus 12 mg for Presumed Paroxysmal Supraventricular Tachycardia (PSVT). Prehospital Emergency Care, 1–6. https://doi.org/10.1080/10903127.2025.2504521
🔗 Read the article: https://www.tandfonline.com/doi/abs/10.1080/10903127.2025.2504521

 

As always THANK YOU for listening.

Hawnwan Philip Moy MD (@pecpodcast)

Scott Goldberg MD, MPH (@EMS_Boston)

Jeremiah Escajeda MD, MPH (@jerescajeda)

Joelle Donofrio-Odmann DO (@PEMems)

Maia Dorsett MD PhD (@maiadorsett)

Lekshmi Kumar MD, MPH(@Gradymed1)

Greg Muller DO (@DrMuller_DO)

Ariana Weber MD (@aweberMD4)

Rebecca Cash PhD (@CashRebeccaE)

Michael Kim MD (@michaeljukim)

Rachel Stemerman PhD (@steminformatics)

Nikolai Arendovich MD