3.12: Bradycardia

Question 1

3.12: Bradycardia Criteria

Answer 1

• Adult
• HR <40, and
• Moderate or severe compromise

Question 2

• Sinus Brady
• Nodal Brady
• 1st degree HB
• 2nd degree HB
• Undifferentiated barrow complex Brady

Answer 2

0.6mg Atropine, repeat PRN

Unresponsive to atropine?

Adrenaline IV (1:1,000,000)
2 drops/second, or
0.01mg every 1-2 minutes PRN

Unresponsive to adrenaline?

Stop adrenaline IV

Initiate Pacing

Question 3

3rd degree HB, or

Undifferentiated broad complex Brady

Answer 3

IV Access
Initiate pacing

Unresponsive to pacing?

Stop pacing

Adrenaline IV (1:1,000,000)
2 drops/second, or
0.01mg every 1-2 minutes PRN

Question 4

Bradycardia in adults is most commonly caused by?

Answer 4

• Myocardial Ischaemia, particularly when SA or AV node is ischaemic. Inferior ischaemia is much more likely to involve these nodes than anterior it anterolateral ischaemia.
• Structural heart disease involving SA node, AV node, or conduction system. Most common in elderly patients.

Question 5

Responsive to pharmocological measures?

Answer 5

Bradycardia caused by a problem high in the conduction system, for example
at the level of the sinoatrial node or atrioventricular node, is most likely to be
responsive to atropine or adrenaline.

• Sinus Brady
• Nodal Brady
• 1st degree HB
• 2nd degree HB
• Undifferentiated barrow complex Brady

Question 6

Responsive to pacing?

Answer 6

Bradycardia caused by a problem low in the conduction system, for example
below the atrioventricular node, is most likely to be responsive to pacing.

3rd degree HB, or

Undifferentiated broad complex Brady