Difference between revisions of "ACLS: Bradycardia"

(Categories)
(Differential)
Line 23: Line 23:
 
**Vasovagal reflex
 
**Vasovagal reflex
 
**Hypersensitive carotid sinus syndrome
 
**Hypersensitive carotid sinus syndrome
**Intra-abdominal hemorrhage (i.e. [[ruptured ectopic]])
+
**Intra-abdominal hemorrhage (i.e. ruptured [[ectopic]])
 
*'''Metabolic/endocrine/environmental'''
 
*'''Metabolic/endocrine/environmental'''
 
**[[Hyperkalemia]]
 
**[[Hyperkalemia]]

Revision as of 01:19, 7 June 2015

This page is for bradycardia with a pulse; for bradycardia without a pulse see Adult Pulseless Arrest (i.e. PEA)

Background

  • Only intervene if pt is symptomatic (hypotension, AMS, chest pain, pulm edema)

Categories

  • Sinus node dysfunction
  • AV node dysfunction
    • 1st degree AV block
    • 2nd degree AV block Mobitz I/Wenckebach
    • 2nd degree AV block Mobitz II
    • 3rd degree AV block (complete heart block)

Differential

Treatment

  1. Atropine
    • Can be used as temporizing measure (while awaiting pacing and/or chronotropes)
    • Use cautiously in patients with ongoing ischemia (tachycardia may worsen ischemia)
    • 0.5mg q3-5min (max 3mg or 6 doses)
      • may not work in 2nd/3rd degree heart block, heart transplant
  2. Chronotropes
  3. Transcutaneous Pacing
  4. Transvenous Pacing

Antidotes for toxicologic causes

See Also

References