Approach to the Patient with Bradycardia and/or Atrioventricular Block - Flowchart
Approach to the Patient with Bradycardia and/or Atrioventricular Block - Flowchart Approach to the Patient with Bradycardia and/or Atrioventricular Block Approach to the Patient with Bradycardia and/or Atrioventricular Block
Flowchart

See Chapter 39 for general approach to the patient with an arrhythmia

See Chapter 39 for general approach to the patient with an arrhythmia

See Chapter 39 for general approach to the patient with an arrhythmia

39

End

End

End

Bradycardia and/or atrioventricular (AV) block (Table 44.1)

Bradycardia and/or atrioventricular (AV) block (Table 44.1)

Bradycardia and/or atrioventricular (AV) block (Table 44.1)

Table 44.1

Key observations (Table 1.1)
Oxygen, ECG monitor, IV access
Focused assessment (Table 39.1)

Key observations (Table 1.1)
Oxygen, ECG monitor, IV access
Focused assessment (Table 39.1)

Key observations (Table 1.1)
Oxygen, ECG monitor, IV access
Focused assessment (Table 39.1)

Table 1.1

Table 39.1

12-lead ECG and rhythm strip
Make diagnosis (Table 44.1, Figs 44.2, 44.3, 44.4, 44.5, 44.6) and consider cause (Tables 44.3, 44.4)

12-lead ECG and rhythm strip
Make diagnosis (Table 44.1, Figs 44.2, 44.3, 44.4, 44.5, 44.6) and consider cause (Tables 44.3, 44.4)

12-lead ECG and rhythm strip
Make diagnosis (Table 44.1, Figs 44.2, 44.3, 44.4, 44.5, 44.6) and consider cause (Tables 44.3, 44.4)


Table 44.1 44.2 44.3 44.4 44.5 44.6 44.3 44.4

Stabilize airway and breathing
Call resuscitation team
Atropine 1 mg IV, repeated as needed to a total of 3 mg, or alternative drugs (Table 44.2)

Stabilize airway and breathing
Call resuscitation team
Atropine 1 mg IV, repeated as needed to a total of 3 mg, or alternative drugs (Table 44.2)

Stabilize airway and breathing
Call resuscitation team
Atropine 1 mg IV, repeated as needed to a total of 3 mg, or alternative drugs (Table 44.2)



Table 44.2

Patient unstable?

Patient unstable?

Patient unstable?

Yes

Yes

Yes

No

No

No

Temporary or permanent cardiac pacing (Table 44.5; Chapter 119)

Temporary or permanent cardiac pacing (Table 44.5; Chapter 119)

Temporary or permanent cardiac pacing (Table 44.5; Chapter 119)

Table 44.5 Chapter 119

Transfer to CCU/high-dependency unit (HDU) for ECG monitoring/observation

Transfer to CCU/high-dependency unit (HDU) for ECG monitoring/observation

Transfer to CCU/high-dependency unit (HDU) for ECG monitoring/observation

Poor response to drug therapy or bradycardia likely to recur?

Poor response to drug therapy or bradycardia likely to recur?

Poor response to drug therapy or bradycardia likely to recur?

Yes

Yes

Yes

No

No

No

Diagnose/treat cause (Tables 44.3, 44.4)
Refer to cardiologist

Diagnose/treat cause (Tables 44.3, 44.4)
Refer to cardiologist

Diagnose/treat cause (Tables 44.3, 44.4)
Refer to cardiologist

44.3 44.4

Discuss management with a cardiologist

Discuss management with a cardiologist

Discuss management with a cardiologist