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 3rd degree or 2nd degree type II heart block?



  YES                                                               NO

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

                                                max 3.0 mg

Prepare for


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





·       Rate

·       Rhythm

·       Blood Pressure