Adult Bradycardia

Question 1

Adult Bradycardia - S/S of poor perfusion

Answer 1

Hypotension
Altered mental status
Shock
Ischemic chest pain
Acute heart failure

Question 2

Adult Bradycardia - Wide QRS >0.12 seconds with known renal failure, dialysis or suspected DKA tx?

Answer 2

Sodium Bicarbonate - 1 mEq/kg

Calcium gluconate 1 g infusion

Question 3

Adult Bradycardia - Sodium Bicarbonate dose

Answer 3

1 mEq/kg IV/IO q 5 min - max 2 mEq/kg

Question 4

Adult Bradycardia - S/S of poor perfusion treatment?

Answer 4

Atropine

Question 5

Adult Bradycardia - Atropine dose

Answer 5

0.5 mg IV/IO q 3 – 5 min to a total max of 3 mg

Question 6

Adult Bradycardia - Atropine indications

Answer 6

Symptomatic bradycardia

Question 7

Adult Bradycardia - Atropine EMS contraindications

Answer 7

Hypersensitivity

Question 8

Adult Bradycardia - Atropine precautions

Answer 8

Pacing may be considered over atropine in patients who have 2° type II or 3° heart block
Administration to heart transplant patient in appropriate because of the denervation of the heart

Question 9

Adult Bradycardia - Atropine ineffective tx?

Answer 9

Transcutaneous pacing

Question 10

Adult Bradycardia - Possible causes

Answer 10

Hypoxemia
Increased parasympathetic (vagal) tone
Intrinsic disease of the SA node or conductive system
Drug effects / overdose
AV junctional ischemia or necrosis
Hyperkalemia
Metabolic acidosis resulting in hyperkalemia

Question 11

Adult Bradycardia - Treatment of bradycardia in patients with chest pain should be reserved for

Answer 11

Hypotensive patients with HR <50 bpm

Question 12

Adult Bradycardia - Calcium gluconate indications

Answer 12

Bradycardia with QRS width > 0.12 s with a history of known renal failure, dialysis or DKA

Question 13

Adult Bradycardia - Calcium gluconate dose?

Answer 13

1 g IV/IO dilute in 50 mL NS over 10 min

Question 14

Adult Bradycardia - Calcium gluconate contraindications?

Answer 14

Hypersensitivity

Hypercalcemia