Winter ECG

Question 0

Name 6 rhythms that can be bradycardia?

Answer 0

Sinus Brady
AV blocks
AFib
Aflutter
Junctional escape
Ventricular escape

Question 1

What is the ACLS definition of bradycardia?

Answer 1

Rate of less than 50 beats

Question 2

Explain the relationship between AFib/aflutter and bradycardia.

Answer 2

Bradycardia is rarely associated with AFib/aflutter outside of over medication of rate controlling drugs.

Question 3

What are the questions to ask with a potential bradycardia patient?

Answer 3

1. Is it bradycardia? (<50)
2. Is the pt. Symptomatic?
3. Are the symptoms caused by the rate?
   4.

Question 4

List 6 possible symptoms of bradycardia hypoperfusion.

Answer 4

1. Chest pain
2. Shortness of breath
3. Decreased LOC
4. Weakness
5. Dizziness
6. Nausea

Question 5

List 5 possible signs of bradycardia related hypoperfusion.

Answer 5

1. Hypotension
2. Diaphoresis
3. Pulmonary edema
4. AMI
5. PVC’s

Question 6

What does MONA stand for?

Answer 6

Morphine
Oxygen
Nitro
Aspirin

Question 7

What are the 3 basics of bradycardia treatment?

Answer 7

Oxygen
Supine positioning
Fluids (if lungs are clear)

Question 8

Based on AHA 2010 guidelines, what is the first line bradycardia treatment?
What are the second line treatments?

Answer 8

1. Atropine

2. TCP, dopamine, epi drip

Question 9

What is the most appropriate bradycardia intervention for an unstable patient? Why?

Answer 9

TCP

It is the fastest option and works on all rhythms

Question 10

Why is treating bradycardia in the setting of an acute MI tricky? What is the solution?

Answer 10

Slow rates may reduce coronary flow and increase ischemia…
Faster rates put more demand on an ischemic myocardium

Treatment should only be given if the severity of the symptoms demand it.

Question 11

What is the dosing, interval, and max for atropine?

Answer 11

0.5mg q.3-5 min. Max 3mg

Question 12

What is the dosage for dopamine or epinephrine drips?

Answer 12

2-10 mcg/min

Question 13

What are the questions to ask for tachycardia patients?

Answer 13

1. Is it tachycardia (>100)
2. Is the pt. Symptomatic?
3. Are the symptoms caused by the tachycardia? (>150 to be considered as a cause for the symptoms)

Question 14

What are some signs of symptoms caused by tachycardia?

Answer 14

Low blood pressure
Diaphoresis
Pulmonary edema
Acute MI
PVCs

Question 15

What are some possible symptoms of a symptomatic tachycardia pt.?

Answer 15

Chest pain
Shortness of breath
Altered mental status
Dizziness
Weakness

Question 16

List 4 potential signs/symptoms of instability caused by tachycardia.

Answer 16

Acute altered mental status
Significant hypotension
Severe chest pain
Severe shortness of breath