Arrhythmia Management - Bradycardia Flashcards
1
Q
How to manage a bradycardia
A
A-E approach
Adverse features present (SBP<90, MI, syncope, HF)
1. atropine 500mcg IV
If there is a satisfactory response - consider if there is a risk of asystole*
- If no risk - observe
- If risk continue as if no satisfactory response
If not a satisfactory response to atropine - consider interim measures:
- Atropine 500mcg IV repeat to maximum of 3mg (6 doses)
- OR transcutaneous pacing
- OR isoprenaline 5mcg / min IV / adrenaline 2-10 mcg/min IV / alternative drugs**
After/during interim measures - seek expert help to arrange transvenous pacing
- Asystole risks
- recent asystole
- mobitz II AV block
- complete heart block with broad QRS
- ventricular pause >3s
- *alternative drugs
- aminophylline
- dopamine
- glucagon (if bradycardia caused by B-blocker or CCB)
- glycopyrrolate - may be used instead of atropine
