Bradycardia Algorithm

Question 0

What are the symptoms of true bradycardia?

Answer 0

AMS
Chest pain
Dizziness
BP < 90 systolic
Shortness of breath
Nausea

Question 1

What is bradycardia?

Answer 1

HR < 60 BPM

Question 2

What’s the first step in treating bradycardia? (Really 3 steps in one)

Answer 2

O2, IV/IO, monitor

Question 3

1st line drug for bradycardia?

Answer 3

Atropine - 0.5 mg rapid IV

Max of 3.0 mg

Question 4

2nd line treatment for bradycardia?

Answer 4

TCP - TransCutaneous Pacing

Question 5

What is the appropriate setting for pacing according to ACLS?

Answer 5

HR 60

mA 60

Question 6

What is the second line drug, third line treatment for bradycardia?

Answer 6

Dopamine - 5.0-10.0 mcg/kg/min

Question 7

What is the low dose of dopamine, and what effect does it have?

Answer 7

1-5 mcg/kg/min

Dopaminergic effect-dilates renal and messengering arteries

Question 8

What is the mid dose of dopamine, and what effect does it have?

Answer 8

5-10 mcg/kg/min

Beta1 stimulation

Question 9

What is the high dose of dopamine, and what effect does it have?

Answer 9

10-20 mcg/kg/min

Alpha1 stimulation

Question 10

What is the fourth line drug for bradycardia?

Answer 10

Epinephrine drip 2 mcg/min