Peri-arrest Rhythms: Bradycardia

Question 1

Peri-arrest Rhythm: Bradycardia:
2015 Resuscitation Council (UK) Guidelines emphasise that the management of bradycardia depends on:
1.
2.

Answer 1

1. Identifying the presence of signs indicating haemodynamic compromise - adverse signs
2. Identifying the risk of asystole.

Question 2

Peri-arrest Rhythm: Bradycardia: Adverse Signs: (indications of haemodynamic compromise and the need for treatment):

Answer 2

Shock: Hypotension (systolic BP < 90 mmHg), pallor, sweating, cold, clammy extremities, confusion or impaired consciousness
Syncope
Myocardial Ischaemia
Heart Failure

Question 3

Peri-arrest Rhythm: Bradycardia: Treatment:

Answer 3

First Line: Atropine 500 mcg IV
If there is unsatisfactory response…
Atropine up to max 3 mg
Transcutaneous Pacing (consider even if responsive to atropine)
Isoprenaline/Adrenaline infusion titrated to response

Question 4

Potential Risk factors for Asystole:

Answer 4

Complete heart block (3rd degree) - broad QRS complex
Recent Asystole
Mobitz type 2 AV block (second degree type 2)
Ventricular pause ( > 3 seconds)