is there any consideration(s) to move away from the '' double syringe method'' to a single syringe method for adenosine ?? - using 20 ml or larger syringe 
meaning adenosine mixed with ns and then pushed as 1 dose - medication and flush ?? 
various studies have shown that is effective, less operational stressors , and easier to manage then attempting use a stop cock valve, ns line wide open with flushes, etc 

SWORBHP is not prescriptive in how you choose to administer adenosine. You can choose to utilize a stop-cock or not along with the flush. As a reminder, the OBHG Companion Document states, “When adenosine is administered, it should be immediately followed by a 20 mL normal saline bolus.”  

As you allude, it works best when given quickly, and hence is suggested to be given via “Rapid IV push”. However, the method in which you administer it, will depend on the unique clinical factors of the call and available resources. 

Cardiac/Circulation,Tachydysrhythmia

Adenosine, Administration technique, Arrhythmia, Rapid IV push, Stopcock, Supraventricular Tachycardia, SVT

ALS PCS 5.4 Companion Document https://ontariobasehospitalgroup.ca/wp-content/uploads/2025/06/ALS-PCS-v5.4-Companion-Document.pdf