130 Symptomatic Bradycardia

Question 1

What are the INDICATIONS for the BRADYCARDIA medical directive?

Answer 1

Bradycardia
Hemodynamic Instability

Question 2

What are the CONDITIONS for ATROPINE in BRADYCARDIA medical directive?

Answer 2

18 years old
HR under 50
Hypotensive

Question 3

What are the CONTRAINDICATIONS for ATROPINE in BRADYCARDIA medical directive?

Answer 3

Allergy
Heart Transplant
Hypothermia

Question 4

What is the dose for ATROPINE in BRADYCARDIA medical directive?

Answer 4

1mg

Question 5

How MANY doses are given of ATROPINE in BRADYCARDIA medical directive?

Answer 5

2

Question 6

Which rhythms will likely benefit from a second atropine dose

Answer 6

Sinus Bradycardia
Junctional Bradycardia
Atrial Fibrillation
1st degree
2nd degree Type 1 (longer, longer, drop)

Question 7

What is a 2nd degree type 1 rhythm?

Answer 7

Longer Longer Drop, now we have a Wenkebach

Question 8

What is the interval between doses for ATROPINE in BRADYCARDIA medical directive?

Answer 8

5 minutes

Question 9

What is the route of administration for ATROPINE in BRADYCARDIA medical directive?

Answer 9

RIVP

Question 10

What is the drug class of atropine

Answer 10

anti-cholinergic
anti-muscarinic
Parasympatholytic

Question 11

How does atropine work?

Answer 11

competitively antagonizes muscarinic receptors on the AV node to block acetylcholine
-decreases parasympathetic tone
-decreases vagal response

positive dromotrope
positive chronotrope

Question 12

What does dromotope mean?

Answer 12

Conduction through the AV

Question 13

What does Chronotrope mean

Answer 13

Heart rate

Question 14

What does inotrope mean

Answer 14

Force of contraction

Question 15

What types of bradycardic OD can EMS fix with other medications?

Answer 15

Betablocker OD: glucagon
Calcium Channel Blocker OD: Calcium gluconate

Question 16

What are the CONDITIONS for DOPAMINE in BRADYCARDIA medical directive?

Answer 16

18 years old
HR under 50
Hypotensive

Question 17

What are the CONTRAINDICATIONS for DOPAMINE in BRADYCARDIA medical directive?

Answer 17

Allergy
Pheochromocytoma
Mechanical Shock

Question 18

What is the initial dose of DOPAMINE in BRADYCARDIA medical directive?

Answer 18

5mcg/kg/minute

Question 19

What increments of DOPAMINE are given in BRADYCARDIA medical directive?

Answer 19

5 mcg/kg/minutes

Question 20

What is the MAX dose for DOPAMINE in BRADYCARDIA medical directive?

Answer 20

20mcg/kg/minute

Question 21

What is the interval between doses for DOPAMINE in BRADYCARDIA medical directive?

Answer 21

5 minutes

Question 22

What is the route of administration for DOPAMINE in BRADYCARDIA medical directive?

Answer 22

IV bolus

Question 23

What blood pressure do we titrate off dopamine?

Answer 23

SBP: 90-110

Question 24

How long do we discontinue Dopamine

Answer 24

5-10 minutes

Question 25

What type of OD does atropine treat?

Answer 25

Cholinergic OD

Question 26

What are the symptoms of cholinergic OD

Answer 26

Red as a beet Hot as a hare Blind as a bat Mad as a hatter Dry and a bone

Question 27

What are the CONDITIONS for PACING in BRADYCARDIA medical directive?

Answer 27

18 years old HR under 50 Hypotensive

Question 28

What are the CONTRAINDICATIONS for PACING in BRADYCARDIA medical directive?

Answer 28

Hypothermia

Question 29

What is the common mAmps for PACING in BRADYCARDIA medical directive?

Answer 29

80-100 mAMPs

Question 30

Which rhythms should we consider pacing early?

Answer 30

2nd degree type 2 and 3rd degree

Question 31

Describe 2nd degree type 2

Answer 31

Regular PR intervals, but missing QRS complexes

Question 32

Why do 2nd degree type 2, and 3rd degree not respond well to atropine?

Answer 32

The ventricles are beating separately from the atria

Question 33

How does atropine come packaged?

Answer 33

preload 1mg/10ml syringe

Question 34

In a STEMI or ROSC, which treatments are preferred

Answer 34

Dopamine/ TCP/ Fluid