Resus - Bradycardia (adult) 2015 Flashcards Preview

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Flashcards in Resus - Bradycardia (adult) 2015 Deck (6)
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1
Q

Step 1

A

ABCDE

  • SpO2 and give oxygen
  • 12-lead ECG
  • BP
  • IV access
  • Treat reversible causes
2
Q

Step 2 (after ABCDE)

A

Adverse features

  • Shock
  • Syncope
  • Myocardial ischaemia
  • Heart failure
3
Q

Adverse features present

A
  • Atropine 500mcg IV

Satisfactory response?

  • Yes - go to no adverse features
  • No - consider interim measures
4
Q

No adverse features

A

Risk of asystole?

  • Recent asystole
  • Mobitz II AV block
  • Complete heart block with broad QRS
  • Ventricular pause over 3s

If yes - consider interim measures
If no - continue observation

5
Q

Interim measures

A

Consider one of

  • Repeat atropine 500mcg IV to maximum 3mg
  • Transcutaneous pacing
  • Isoprenaline 5mcg/min IV
  • Adrenaline 2-10mcg/min IV
  • Alternative drugs e.g. aminophylline, dopamine, glucagon (if cause is beta-blocker or calcium channel blocker), glycopyrolate (alternative to atropine)
6
Q

After interim measures

A
  • Seek expert help

- Arrange transcutaneous pacing