If Pt is unstable (CP, decreased BP, SOB, or AMS), call a code/notify physician STAT. Pt requires immediate intervention!

• Atropine: Give 0.5 mg IV every 3 to 5 min to a maximum of 3 mg.
• If atropine ineffective:
• Pace: Begin transcutaneous pacing (Do not delay for second-degree type 2 or third-degree AV block.) or
• Dopamine: 2 to 20 mcg/kg/min, titrate to response, taper slowly or
• Epinephrine: 2 to 10 mcg/min infusion, titrate to response.
• Expert consultation: Definitive care may require transvenous pacing.