Bradycardia Algorithm
Bradycardia Algorithm - Flowchart Bradycardia Algorithm Bradycardia Algorithm
«Flowchart»

1

BRADYCARDIA
Heart rate < 50 bpm and inadequate for clinical condition

1

BRADYCARDIA
Heart rate < 50 bpm and inadequate for clinical condition

1

1

BRADYCARDIA
Heart rate < 50 bpm and inadequate for clinical condition

BRADYCARDIA
Heart rate < 50 bpm and inadequate for clinical condition


Maintain patent airway; assist breathing as needed
Give oxygen
Monitor ECG (identify rhythm), blood pressure, oximetry
Establish IV access


Maintain patent airway; assist breathing as needed
Give oxygen
Monitor ECG (identify rhythm), blood pressure, oximetry
Establish IV access


Maintain patent airway; assist breathing as needed
Give oxygen
Monitor ECG (identify rhythm), blood pressure, oximetry
Establish IV access


Maintain patent airway; assist breathing as needed breathing
Give oxygen oxygen
Monitor ECG (identify rhythm), blood pressure, oximetry
Establish IV access

4


Prepare for transcutaneous pacing; use without delay for high-degree block (type II second-degree block or third-degree AV block).
Consider atropine 1mg IV while awaiting pacer. May repeat to a total dose of 3 mg. If ineffective, begin pacing.
Consider epinephrine (2 -10 µg/min) or dopamine (5 - 20 µg/kg/min) infusion while awaiting pacer or ifpacing ineffective.

4


Prepare for transcutaneous pacing; use without delay for high-degree block (type II second-degree block or third-degree AV block).
Consider atropine 1mg IV while awaiting pacer. May repeat to a total dose of 3 mg. If ineffective, begin pacing.
Consider epinephrine (2 -10 µg/min) or dopamine (5 - 20 µg/kg/min) infusion while awaiting pacer or ifpacing ineffective.

4

4


Prepare for transcutaneous pacing; use without delay for high-degree block (type II second-degree block or third-degree AV block).
Consider atropine 1mg IV while awaiting pacer. May repeat to a total dose of 3 mg. If ineffective, begin pacing.
Consider epinephrine (2 -10 µg/min) or dopamine (5 - 20 µg/kg/min) infusion while awaiting pacer or ifpacing ineffective.


Prepare for transcutaneous pacing; use without delay for high-degree block (type II second-degree block or third-degree AV block). Prepare for transcutaneous pacing;
Consider atropine 1mg IV while awaiting pacer. May repeat to a total dose of 3 mg. If ineffective, begin pacing. atropine
Consider epinephrine (2 -10 µg/min) or dopamine (5 - 20 µg/kg/min) infusion while awaiting pacer or ifpacing ineffective. epinephrine dopamine

4A

Observe/Monitor

4A

Observe/Monitor

4A

4A

Observe/Monitor

End

End

End

5


Prepare for transvenous pacing
Treat contributing causes
Consider expert consultationSigns

5


Prepare for transvenous pacing
Treat contributing causes
Consider expert consultationSigns

5

5


Prepare for transvenous pacing
Treat contributing causes
Consider expert consultationSigns


Prepare for transvenous pacing transvenous pacing
Treat contributing causes
Consider expert consultationSigns

3

Signs or symptoms of poor perfusion caused by the bradycardia?
(e.g., acute altered mental status, ongoing chest pain, hypotension or other signs of shock)

3

Signs or symptoms of poor perfusion caused by the bradycardia?
(e.g., acute altered mental status, ongoing chest pain, hypotension or other signs of shock)

3

3

Signs or symptoms of poor perfusion caused by the bradycardia?
(e.g., acute altered mental status, ongoing chest pain, hypotension or other signs of shock)

Signs or symptoms of poor perfusion caused by the bradycardia? Signs or symptoms of poor perfusion caused by the bradycardia?

Poor Perfusion

Poor Perfusion

Poor Perfusion Poor Perfusion

Adequate Perfusion

Adequate Perfusion

Adequate Perfusion Adequate Perfusion

Reminders


If pulseless arrest develops, go to Pulseless Arrest Algorithm
Search for and treat possible contributing factors:


Hypovolemia
Hypoxia
Hydrogen ion (acidosis)
Hypo-/hyperkalemia
Hypoglycemia
Hypothermia
Toxins
Tamponade, cardiac
Tension pneumothorax
Thrombosis (coronary or pulmonary)
Trauma (hypovolemia, increased ICP)

Reminders


If pulseless arrest develops, go to Pulseless Arrest Algorithm
Search for and treat possible contributing factors:


Hypovolemia
Hypoxia
Hydrogen ion (acidosis)
Hypo-/hyperkalemia
Hypoglycemia
Hypothermia
Toxins
Tamponade, cardiac
Tension pneumothorax
Thrombosis (coronary or pulmonary)
Trauma (hypovolemia, increased ICP)

Reminders

Reminders Reminders


If pulseless arrest develops, go to Pulseless Arrest Algorithm
Search for and treat possible contributing factors:


Hypovolemia
Hypoxia
Hydrogen ion (acidosis)
Hypo-/hyperkalemia
Hypoglycemia
Hypothermia
Toxins
Tamponade, cardiac
Tension pneumothorax
Thrombosis (coronary or pulmonary)
Trauma (hypovolemia, increased ICP)


If pulseless arrest develops, go to Pulseless Arrest Algorithm
Search for and treat possible contributing factors:


Hypovolemia
Hypoxia
Hydrogen ion (acidosis)
Hypo-/hyperkalemia
Hypoglycemia
Hypothermia
Toxins
Tamponade, cardiac
Tension pneumothorax
Thrombosis (coronary or pulmonary)
Trauma (hypovolemia, increased ICP)


Hypovolemia H
Hypoxia H
Hydrogen ion (acidosis) H
Hypo-/hyperkalemia H
Hypoglycemia H
Hypothermia H
Toxins T
Tamponade, cardiac T
Tension pneumothorax T
Thrombosis (coronary or pulmonary) T
Trauma (hypovolemia, increased ICP) T

AV, atrioventricular; bpm, beats per minute; ICP, intracranial pressure.

AV, atrioventricular; bpm, beats per minute; ICP, intracranial pressure.

AV, atrioventricular; bpm, beats per minute; ICP, intracranial pressure.