treat sinus bradycardia with medications

  • atropine
    • atropine removes vagal tone at AV node. If block happens after AV node, then atropine is not useful: bradycardia can happen after MI
    • atropine not effective for 2nd degree type 2 or complete heart block
    • ACLS dosing: first dose: 1 mg bolus
  • dopamine gtt second line
    • beta adrenergic at 5-10 mcg/kg and +alpha adrenergic at > 10 mcg/kg. Usually 5-20 mcg/kg
  • epinephrine gtt 3rd line
    • 2-10 mcg/min
  • transcutaneous pacing or temporary pacing wire (preferred) placement if unstable or asystole
  • transplant patients can be very sensitive or not sensitive at all 12

Footnotes

  1. CHEST Board Review Critical Care? ↩

  2. Heartcode ACLS? ↩