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
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