ACLS: Bradycardia

Revision as of 01:04, 7 June 2015 by Rossdonaldson1 (talk | contribs) (Differential)

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