Bradycardia and Its Treatment Overview

Questions and Answers

A symptomatic bradycardia exists when what 3 criteria are present?

1. The heart rate is slow. 2. The patient has symptoms. 3. The symptoms are due to the slow heart rate. (correct)

1. The heart rate is fast. 2. The patient has symptoms. 3. The symptoms are due to the fast heart rate.

1. The heart rate is slow. 2. The patient has no symptoms. 3. The lack of symptoms are due to the slow heart rate.

None of the above

The primary decision point in the ACLS Bradycardia Algorithm is:

The presence of chest pain

The determination of adequate perfusion (correct)

The patient's heart rate

The patient's blood pressure

Identify the correct dosing regimen of atropine to treat symptomatic bradycardia:

Atropine 0.5 mg IV every 2 minutes to a maximum of 2 mg

Atropine 1 mg every 5 minutes to a maximum of 3 mg

Atropine 1 mg IV every 3-5 minutes to a maximum of 3 mg

Atropine 0.5 mg IV every 3-5 minutes to a maximum of 3 mg (correct)

What is not a precaution for Transcutaneous Pacing?

Avoid AV nodal blocking agents Signup and view all the answers

Identify the correct sequence of steps to perform TCP (transcutaneous pacing):

Place pacing electrodes on the chest. Turn the pacer on. Set the demand rate to 60 beats/min. This rate can be adjusted up or down once pacing is established. Set the current milliamperes output 2 mA above the dose at which consistent capture is observed. Signup and view all the answers

What drugs are appropriate forms of treatment according to the Adult Bradycardia with a Pulse Algorithm?

All of the above Signup and view all the answers

The initial treatment for bradycardia is:

Atropine Signup and view all the answers

What is the next intervention for a patient with third degree heart block who is symptomatic after receiving atropine?

Consider transcutaneous pacing (TCP) or other interventions as necessary. Signup and view all the answers

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.

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.