Bradycardia

In an adult, bradycardia is a rhythm with a rate <50 per minute. Bradycardia is defined as symptomatic when any or all of these symptoms occur:

For Bradycardia:

1. Do not delay treatment but look for underlying causes of the bradycardia using the H's and T's (see Figure 4 & Table 8).

2. Maintain the airway and monitor cardiac rhythm, blood pressure and oxygen saturation.

3. Insert an IV or IO for medications.

4. If the patient is stable, call for consults.

5. If the patient is symptomatic, administer atropine 500 mcg IV or IO bolus and repeat the atropine every 3‑5 minutes to a total dose of 3 mg:

6. If atropine does not relieve the bradycardia, continue evaluating the patient to determine the underlying cause and consider transcutaneous pacing.

7. Consider an IV/IO dopamine infusion at 2-10 mcg/kg/minute.

8. Consider an IV/IO epinephrine infusion at 2-10 mcg/minute.

Interim measures:

• Atropine 500 mcg IV repeat to max 3 mg
• Isoprenaline 5 mcg min1 IV
• Adrenaline 2 - 10 mcg min1 IV
• Alternative drugs (Aminophylline, dopamine, glucacon esp. in case of beta-blocker or CCB overdose, Glycopyrrolate)