Questions and Answers
A symptomatic bradycardia exists when what 3 criteria are present?
The primary decision point in the ACLS Bradycardia Algorithm is:
Identify the correct dosing regimen of atropine to treat symptomatic bradycardia:
What is not a precaution for Transcutaneous Pacing?
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Identify the correct sequence of steps to perform TCP (transcutaneous pacing):
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What drugs are appropriate forms of treatment according to the Adult Bradycardia with a Pulse Algorithm?
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The initial treatment for bradycardia is:
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What is the next intervention for a patient with third degree heart block who is symptomatic after receiving atropine?
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Study Notes
Bradycardia and Treatment Overview
- Symptomatic bradycardia requires three criteria: slow heart rate, presence of symptoms, and symptoms must be due to the slow heart rate.
- Primary decision point in the ACLS Bradycardia Algorithm is the determination of adequate perfusion.
- In cases of poor perfusion, immediate treatment is necessary.
Atropine Administration
- Correct dosing regimen for atropine: 0.5 mg IV every 3-5 minutes, up to a maximum of 3 mg.
- Atropine must be used cautiously in cardiac ischemia as it may worsen the condition.
- Doses lower than 0.5 mg can paradoxically slow the heart rate.
Transcutaneous Pacing (TCP) Precautions
- TCP is contraindicated in severe hypothermia and not recommended for asystole.
- Conscious patients require analgesia for discomfort during TCP procedures.
- Do not assess carotid pulse for mechanical capture; electrical stimulation may cause muscular jerking.
Steps for Transcutaneous Pacing
- Sequence: Place pacing electrodes on the chest, turn the pacer on, set the demand rate to 60 beats/min (adjust as needed), and set the current output 2 mA above the level for consistent capture.
Treatment Protocols for Bradycardia
- Appropriate treatments under the Adult Bradycardia with a Pulse Algorithm include atropine, dopamine, and epinephrine.
- Initial treatment for bradycardia in cases of poor perfusion is atropine.
Advanced Patient Scenarios
- For a patient with third-degree heart block experiencing chest pain, hypotension, and pulmonary congestion after receiving atropine with minimal effect, additional interventions are needed beyond initial atropine administration.
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Description
This quiz covers the critical aspects of bradycardia, including its symptoms, the ACLS algorithm, and the administration of atropine. It also discusses precautions related to transcutaneous pacing and the necessary steps to perform it safely. Test your knowledge on the management of symptomatic bradycardia and related interventions.