Bradyarrhythmias is a topic covered in the Pocket ICU Management.

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First Things First (assess & treat for the following)

  • Bradycardia = ventricular rate < 50-60 bpm
    • Can be normal (sinus bradycardia)
    • Can be abnormal
      • Sinus node dysfunction
      • Conduction block
  • Assess hemodynamic status:
    • Is pt hypotensive?
    • Is there evidence of tissue hypoperfusion?
    • Evaluate for CHF.
    • Evaluate for active ischemia.
  • If any of the above are yes, then the pt is unstable & requires immediate treatment per ACLS.
  • Treatment of SYMPTOMATIC bradycardia
    • Atropine (anticholinergic): 0.5-1 mg
    • Isoproterenol (beta agonist): 2-10 mcg/min
    • Temporary pacing
      • Transcutaneous pacing
      • Transvenous pacing
    • Epinephrine: 2-10 mcg/min
    • Dopamine: 5-20 mcg/min

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Last updated: April 9, 2010