Bradycardia

Question 1

What are important ssx of bradycardia?

Answer 1

Decreased level of consciousness, Shortness of breath, PVCs – brady escape, pulmo congestion on PE or cxr

Question 2

What are the signs that would lead one to give atropine in bradycardia?

Answer 2

Hypotension
Acutely altered mental status
Signs of shock
Ischemic chest discomfort
Acute heart failure

Question 3

How is atropine given?

Answer 3

0.5mg every 3-5 mins until 3mg

Question 4

What are alternative to atropine?

Answer 4

Transcutaneuous pacing
Epinephrine 2-10mcg/min
Dopamine 2-10mcg/kg/min

Question 5

Which patients require immediate pacing?

Answer 5

High degree AV block (Mobitz T2 second degree AV block, Third degree AV block)
Unstable patients

Question 6

When is stand by pacing required?

Answer 6

1 Mobitz T2 second degree AV block
2 Third degree AV block
3 Symptomatic sinus node dynfunction
4 with severe symptomatic sinus bradycardia
5. newly acquired left right or alternating BBBB or bifascicular block in the setting of AMI