Bradycardia Flashcards

1
Q

Clinical features of bradycardia:

A

HR less than 60
Possible hypotension
Dizziness, mental status changes, nausea/vomiting

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2
Q

DDX of bradycardia (CNS)

A

increased ICP
vagal stimulation
spinal shock

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3
Q

DDX of bradycardia: CV

A

MI
sick sinus syndrome
AV blocks

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4
Q

What is sick sinus syndrome?

A

SA node degeneration leading to bradycardia and often complicated by intermittent SVT

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5
Q

DDX of bradycardia: pulmonary

A

Hypoxemia

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6
Q

DDX of bradycardia-metabolic:

A

acidosis, hypothermia

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7
Q

DDX of bradycardia-endocrine

A

hypothyroidism, adrenal insufficiency

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8
Q

DDX of bradycardia: drugs

A
beta blockers
anesthetic drugs 
K+ (otassium levels above 6,0 mmol/l cause peaked T waves, wider QRS komplexes and may result in bradycardia, asystole and sudden death.)
Ca++ (hypocalcemia) 
digoxin
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9
Q

How do you manage bradycardia?

A
Verify Brady (HR tracing on SpO2, EKG, manual pulse)
Maintain patent airway
confirm rhythm on EKG 
Surgical causes (traction on bowel)
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10
Q

If bradycardia starts changing mental status, causing chest pain, or hypotension, then what?

A

Atropine 0.5 mg IV
epinephrine 10 micrograms to 20 microgram bolus
infusion of epic (2-10 mcg/min)
If refractory to pharmacologic measures, prepare for transcutaneous pacing

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11
Q

If bradycardia has mild symptoms (mild-moderate hypotension, nausea/vomiting), then what?

A

Give atropine 0.4 mg IV
ephedrine 5-10 mg IV
glycopyrrolate 0.2 mg

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