Symptomatic Bradycardia

Assess and maintain ABCs

Administer O2

Assess vitals         

Apply monitors

(EKG, Pulse Ox, B/P)

Review History

Physical Exam

Establish IV Access

Evaluate Rhythm

Wide complex 3^rd degree or 2^nd degree type II heart block?

  YES                                                               NO

Atropine 0.5mg IVP (repeat q 3-5 min)

                                                max 3.0 mg

Prepare for

transcutaneous

pacing                                    Transcutaneous pacemaker if available

Dopamine infusion

5-20 ug/kg/min titrate to SBP >90

Epinephrine infusion

2-10 ug/kg/min titrate to heart rate >60

Prepare for transvenous pacer

Treat:

·       Rate

·       Rhythm

·       Blood Pressure