Table 2.

Checklist for adenosine stress myocardial test

Pre-procedure	Checked
I. Check for contraindication for adenosine stress test
1. Known hypersensitivity to adenosine
2. Known or suspected bronchoconstrictive or bronchospastic disease
3. Heart block more than first degree
4. Significant sinus bradycardia (resting heart rate <45 bpm)
5. Systemic arterial hypotension (<90 mmHg) or severe arterial hypertension
6. Recent myocardial infarction within 3 days
II. Obtain informed consent
III. Perform pre-procedure 12 leads ECG and review by doctor in charge
IV. Place two angiocatheters intravenously to each arm:
1. One IV 20G in antecubital fossa for contrast
2. One IV 20–22G for adenosine infusion
V. Set up infusion pump for adenosine:
Drugs dosage: adenosine 0.14mg/kg/min
Patient’s body weight (BW) = _________ kg; Adenosine concentration _________mg/ml
0.140 (mg/kg/min) × BW (kg)/Adenosine concentration (mg/ml) =
Infusion rate _________ (ml/min) =_________ (ml/h)
Total dose of adenosine to be administrated:
0.14 (mg/kg/min) × BW (kg) × Infusion time (min) = _________ mg
During-procedure
1. Oxygen 2 l/min per nasal cannula
2. Set BP cuff to manual mode. Place BP cuff opposite arm as med administration.
3. Record baseline vital signs- prior to medication administration
4. Aminophylline 125 mg in 50 ml normal saline IVB over 5–6 min prn chest pain and shortness of breath
5. Start adenosine infusion at am/pm (time). Continue vital sign monitoring as shown
Post procedure
1. Perform post stress ECG and review
2. Record final vital signs prior to discharge. Report any patient complaints to doctor in charge