Adult Bradycardia with Pulse Algorithm

Question 1

bradycardia is defined as HR

Answer 1

50/min

Question 2

1st step when bradycardia identified…

Answer 2

treat underlying cause

Question 3

5 initial interventions with bradycardia

Answer 3

maintain airway

O2 PRN

Cardiac monitor, BP + Pulse-Ox

IV access

12 lead ECG

Question 4

5 signs that indicate additional intervention if bradycardia…

Answer 4

hypotension
AMS
signs of shock
angina
acute HF

Question 5

if symptomatic bradycardia identified… what is 1st line drug and dose?

Answer 5

atropine 0.5mg bolus q 3-5 minutes

max dose 3 mg

Question 6

If bradycardia is refractory to atropine, what 3 options are available?

Answer 6

transcutaneous pacing

DA 2-20mcg/kg/min IV infusion

Epi 2-10mcg/min IV infusion

Question 7

dose of DA infusion if bradycardia refractory to atropine administration…

Answer 7

2-20mcg/kg/min

titrate to pt. response

Question 8

dose of epi infusion if bradycardia refractory to atropine administration…

Answer 8

2-10mcg/min

titrate to pt. response

Question 9

3 examples of rhythms that can lead to symptomatic bradycardia…

Answer 9

AV Blocks:

1st degree AV block
2nd degree AV block type I
2nd degree AV block type II
3rd degree AV block