Questions and Answers
Symptomatic bradycardia exists when __________.
the patient has symptoms
Symptoms of bradycardia can include chest discomfort or pain, shortness of breath, decreased level of consciousness, weakness, fatigue, lightheadedness, dizziness, and presyncope or syncope.
True
Signs of symptomatic bradycardia include hypotension, orthostatic hypotension, diaphoresis, pulmonary congestion, runs of PVC's or VT.
True
Atropine doses of less than 0.5 mg may paradoxically result in further slowing of the heart rate.
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The treatment of choice for symptomatic bradycardia with signs of poor perfusion is ____________.
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Define complete block.
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Define sinus bradycardia.
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Even a 5- to 10-second pause in chest compressions can reduce the chance that a shock will terminate VF.
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Chest compressions should be continued while the defibrillator is charging.
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Study Notes
Bradycardia and Treatment Protocols
- Third-degree AV block is the most significant degree of block clinically.
- The Bradycardia Algorithm involves atropine, epinephrine, and dopamine.
- Bradyarrhythmia is identified as any rhythm disorder with a heart rate below 60 beats per minute.
Symptomatic Bradycardia
- Symptomatic bradycardia requires the presence of symptoms due to a slow heart rate.
- Symptoms can include chest discomfort, shortness of breath, weakness, fatigue, lightheadedness, dizziness, and syncope.
- Signs of symptomatic bradycardia include hypotension, diaphoresis, and pulmonary congestion.
Key Protocol Insights
- Adequate perfusion assessment is crucial in the bradycardia algorithm.
- If perfusion is inadequate, atropine should be administered while preparing for possible transcutaneous pacing.
- Atropine is the first-line agent for treating symptomatic bradycardia, with a correct dosage of 0.5 mg that may be repeated up to 3 mg.
Advanced Interventions
- Transcutaneous pacing is the preferred treatment in cases of symptomatic bradycardia with poor perfusion.
- If transcutaneous pacing fails, prepare for transvenous pacing.
- Indications for transcutaneous pacing include unstable sinus bradycardia, third-degree AV block, and Mobitz type II block.
ECG and Medications
- Mobitz II is a recognized ECG rhythm associated with bradycardia.
- The correct infusion rate for dopamine in the bradycardia algorithm is 2-20 mcg/kg/min.
- The infusion rate for epinephrine in the bradycardia algorithm is set at 2-10 micrograms/min.
Defibrillation and Cardiac Arrest Protocols
- The primary treatment for VF and pulseless VT is high-energy unsynchronized shocks.
- Following the first shock in cases of pulseless VF/VT, CPR should immediately resume.
- In biphasic defibrillators, the initial energy dose typically ranges from 120-200 J.
Additional Information
- Continuous chest compressions are important even while charging the defibrillator.
- Interruptions in chest compressions, even for 5-10 seconds, can decrease the chance of successfully terminating VF.
- Conditions like severe hypothermia contraindicate transcutaneous pacing.
Medication Insights
- Atropine doses below 0.5 mg may cause paradoxical bradycardia.
- For persistent bradycardia unresponsive to atropine, epinephrine should be considered.
- Synchronized cardioversion is appropriate for certain forms of cardiac arrest but not for asystole.
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Description
Test your knowledge of Advanced Cardiac Life Support (ACLS) practices with these flashcards. Each card covers key concepts like AV blocks and emergency drugs used in bradycardia. Perfect for healthcare professionals preparing for ACLS certification or review.
