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Bradycardia Management Algorithm

This document provides an algorithm for managing bradycardia in adults and pediatrics. It outlines steps for airway, breathing, circulation, establishing IV access, performing ECG and identifying causes of instability. For unstable adult bradycardia it recommends atropine or adrenaline. For unstable pediatric bradycardia it recommends starting CPR and administering adrenaline or atropine. It also lists alternative treatments and notes when specialist advice should be sought.

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Gideon Bahule
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182 views1 page

Bradycardia Management Algorithm

This document provides an algorithm for managing bradycardia in adults and pediatrics. It outlines steps for airway, breathing, circulation, establishing IV access, performing ECG and identifying causes of instability. For unstable adult bradycardia it recommends atropine or adrenaline. For unstable pediatric bradycardia it recommends starting CPR and administering adrenaline or atropine. It also lists alternative treatments and notes when specialist advice should be sought.

Uploaded by

Gideon Bahule
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

BRADYCARDIA MANAGEMENT

ALGORITHM
2015
AIRWAY 2015

Open, maintain and protect as necessary

BREATHING
Administer oxygen if required. Target Saturation 94-98%
Ventilate if necessary

CIRCULATION
Assess pulse, blood pressure and
perfusion
Attach ECG monitor, pulse oximeter
and vital signs monitor if available

DRIP
Establish IV access

ECG RHYTHM
Run rhythm strip to confirm dysrhythmia SPECIALIST MEDICAL ADVICE
12 lead ECG if possible SHOULD BE SOUGHT
Identify and treat underlying causes WHENEVER POSSIBLE

SIGNS OF INSTABILITY
• Hypotension
• Acutely altered mental state
• Signs of shock
ADULT • Ischaemic chest discomfort PAEDIATRIC
• Acute heart failure

BRADYCARDIA BRADYCARDIA
HR < 50/min Look for and treat HR < 60/min despite effective
contributory causes oxygenation and ventilation
IF UNSTABLE of Bradycardia
ATROPINE IF UNSTABLE
(Exclude Hypoxia/Hypothermia/ • Hypoxia START CPR
Head injury) • Hypothermia 1 Rescuer = 30 compressions : 2 breaths
• Head Injury 2 Rescuers = 15 compressions : 2 breaths
0.5 mg IV bolus • Hyperkalaemia
Can repeat every 3 - 5 minutes, • Heart Block
up to 3 mg ADRENALINE
• Hydrogen Ion (Acidosis) 0.1 ml/kg IV of 1:10 000 dilution
ADRENALINE • Hypotension (Max - 1 mg) every 3 - 5 minutes
(0.05μg/kg/min 0.5 μg/kg/min
infusion) • Toxins
(e.g. organophosphates) ATROPINE
OR
0.02 mg/kg IV if vagal tone or
TRANSCUTANEOUS PACING
• Theraputic Agents 1° AV block
Alternatives (e.g. beta blocker overdose/ Maximum 0.5mg
• Transvenous pacing calcium channel blocker
• High dose Insulin (1 U/kg if BB or CCB) overdose) CONSIDER PACING
• Glucagon (if BB or CCB overdose)
* BB = Beta Blockers
* CCB = Calcium Channel Blockers

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