Bradycardia algorithm

Question 1

Bradycardia algorithm step 3-6:

Answer 1

Step 3: Is the bradyarrhythmia causing:
- HypoT, AMS, shock, chest discomfort, AHF
Step 4: if no: monitor and observe
Step 5:
If yes => Atropine 0.5 mg up to 3 mg or
- Dopamine 2-20 mcg/kg per min
- Epinephrine 2-10 mcg/min
- Transcutaneous pacing
Step 6: Expert consult, transvenous pacing

Question 2

Bradycardia: when is atropine not indicated?

Answer 2

• Mobitz type 2, second degree heart block (intermitient non-conducting P waves w/o progressive prolongation)
• Third degree AV block

Question 3

Bradycardia drug dose details

Answer 3

Atropine IV:
- 1st: 0.5 mg bolus
- repeat every 3-5 mintues
- max: 3 mg
Dopamine IV: 2-20 mcg/kg per min
- titrate to response
Epinephrine IV: 2-10 mcg/min
- titrate to response

Question 4

Bradycardia algorithm step 1-2:

Answer 4

Step 1: Access clinical condition
- HR: less than 50bpm
Step 2: 
- Maintain airway, assess breathing
- O2 if hypoxemic
- Cardiac monitor, BP, O2 sat
- IV access
- ECG if available, don't delay therapy