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EMT > 130 Symptomatic Bradycardia > Flashcards

130 Symptomatic Bradycardia Flashcards

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1
Q

What are the INDICATIONS for the BRADYCARDIA medical directive?

A

Bradycardia
Hemodynamic Instability

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2
Q

What are the CONDITIONS for ATROPINE in BRADYCARDIA medical directive?

A

18 years old
HR under 50
Hypotensive

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3
Q

What are the CONTRAINDICATIONS for ATROPINE in BRADYCARDIA medical directive?

A

Allergy
Heart Transplant
Hypothermia

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4
Q

What is the dose for ATROPINE in BRADYCARDIA medical directive?

A

1mg

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5
Q

How MANY doses are given of ATROPINE in BRADYCARDIA medical directive?

A

2

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6
Q

Which rhythms will likely benefit from a second atropine dose

A

Sinus Bradycardia
Junctional Bradycardia
Atrial Fibrillation
1st degree
2nd degree Type 1 (longer, longer, drop)

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7
Q

What is a 2nd degree type 1 rhythm?

A

Longer Longer Drop, now we have a Wenkebach

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8
Q

What is the interval between doses for ATROPINE in BRADYCARDIA medical directive?

A

5 minutes

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9
Q

What is the route of administration for ATROPINE in BRADYCARDIA medical directive?

A

RIVP

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10
Q

What is the drug class of atropine

A

anti-cholinergic
anti-muscarinic
Sympatholytic

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11
Q

How does atropine work?

A

competitively antagonizes muscarinic receptors on the AV node to block acetylcholine
-decreases parasympathetic tone
-decreases vagal response

positive dromotrope
positive chronotrope

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12
Q

What does dromotope mean?

A

Conduction through the AV

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13
Q

What does Chronotrope mean

A

Heart rate

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14
Q

What does inotrope mean

A

Force of contraction

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15
Q

What types of bradycardic OD can EMS fix with other medications?

A

Betablocker OD: glucagon
Calcium Channel Blocker OD: Calcium gluconate

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16
Q

What are the CONDITIONS for DOPAMINE in BRADYCARDIA medical directive?

A

18 years old
HR under 50
Hypotensive

17
Q

What are the CONTRAINDICATIONS for DOPAMINE in BRADYCARDIA medical directive?

A

Allergy
Pheochromocytoma
Mechanical Shock

18
Q

What is the initial dose of DOPAMINE in BRADYCARDIA medical directive?

A

5mcg/kg/minute

19
Q

What increments of DOPAMINE are given in BRADYCARDIA medical directive?

A

5 mcg/kg/minutes

20
Q

What is the MAX dose for DOPAMINE in BRADYCARDIA medical directive?

A

20mcg/kg/minute

21
Q

What is the interval between doses for DOPAMINE in BRADYCARDIA medical directive?

A

5 minutes

22
Q

What is the route of administration for DOPAMINE in BRADYCARDIA medical directive?

A

IV bolus

23
Q

What blood pressure do we titrate off dopamine?

A

SBP: 90-110

24
Q

How long do we discontinue Dopamine

A

5-10 minutes

25
Q

What type of OD does atropine treat?

A

Cholinergic OD

26
Q

What are the symptoms of cholinergic OD

A

Red as a beet
Hot as a hare
Blind as a bat
Mad as a hatter
Dry and a bone

27
Q

What are the CONDITIONS for PACING in BRADYCARDIA medical directive?

A

18 years old
HR under 50
Hypotensive

28
Q

What are the CONTRAINDICATIONS for PACING in BRADYCARDIA medical directive?

A

Hypothermia

29
Q

What is the common mAmps for PACING in BRADYCARDIA medical directive?

A

80-100 mAMPs

30
Q

Which rhythms should we consider pacing early?

A

2nd degree type 2 and 3rd degree

31
Q

Describe 2nd degree type 2

A

Regular PR intervals, but missing QRS complexes

32
Q

Why do 2nd degree type 2, and 3rd degree not respond well to atropine?

A

The ventricles are beating separately from the atria

33
Q

How does atropine come packaged?

A

preload 1mg/10ml syringe

34
Q

In a STEMI or ROSC, which treatments are preferred

A

Dopamine/ TCP/ Fluid

EMT (34 decks)

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