Bradycardia

Question 1

What kind of patient history should you get?

Answer 1

-OPQRST/SAMPLE
- Hx of HTN, hyperlipidemia, MI, renal disease, hypothyroidism
- Hx of syncope/near syncope
- Hx of beta-blockers, calcium channel blockers, digoxin
- Pacemaker

Question 2

What are some s/s to look out for?

Answer 2

• Heart rate <60 bpm
• Dizzy, lightheaded, syncope, chest pain, fatique, SOB
• acute CHF (peripheral edema, pulmonary crackles/rales, hypoxia)
• Hypotension, shock AMS, pale/cyanotic

Question 3

What are the guidelines for SL1?

Answer 3

• General patient care/OLMD as needed
• Airway management
• BGL
• Suspected overdose

Question 4

What are the guidelines for SL2?

Answer 4

• Asymptomatic
• Cardiac monitoring and 12 lead EKG

Question 5

What do you do i a patient is asymptomatic?

Answer 5

Closely monitor, no intervention needed

Question 6

What are the guidelines for SL3?

Answer 6

• EtCO2
• Vascular Access

Question 7

How should norepinephrine/eprinephrine be adminstered?

Answer 7

With an infusion pump or 60 gtt tubing

Question 8

What do you do with a symptomatic/unstable bradycardia?

Answer 8

Proceed directly to transcutaneous pacing and do not delay treatment to give atropine

Question 9

What are some treatable causes of bradycardia?

Answer 9

• Hypoxia
• Hypothermia
• Calcium Channel Overdose
• Beta blocker overdose

Question 10

What may not respond to atropine?

Answer 10

• Second degree heart blocks
• Third degree heart blocks
• Denervated hearts