Bradycardia resident survival guide: Difference between revisions
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Figure 1: '''Management of patients with Bradycardia:<ref name="Neumar-2010">{{Cite journal | last1 = Neumar | first1 = RW. | last2 = Otto | first2 = CW. | last3 = Link | first3 = MS. | last4 = Kronick | first4 = SL. | last5 = Shuster | first5 = M. | last6 = Callaway | first6 = CW. | last7 = Kudenchuk | first7 = PJ. | last8 = Ornato | first8 = JP. | last9 = McNally | first9 = B. | title = Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal = Circulation | volume = 122 | issue = 18 Suppl 3 | pages = S729-67 | month = Nov | year = 2010 | doi = 10.1161/CIRCULATIONAHA.110.970988 | PMID = 20956224 }}</ref> | Figure 1: '''Management of patients with Bradycardia:<ref name="Neumar-2010">{{Cite journal | last1 = Neumar | first1 = RW. | last2 = Otto | first2 = CW. | last3 = Link | first3 = MS. | last4 = Kronick | first4 = SL. | last5 = Shuster | first5 = M. | last6 = Callaway | first6 = CW. | last7 = Kudenchuk | first7 = PJ. | last8 = Ornato | first8 = JP. | last9 = McNally | first9 = B. | title = Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal = Circulation | volume = 122 | issue = 18 Suppl 3 | pages = S729-67 | month = Nov | year = 2010 | doi = 10.1161/CIRCULATIONAHA.110.970988 | PMID = 20956224 }}</ref> | ||
{{Family tree/start}} | {{Family tree/start}} | ||
{{Family tree | | | | A01 | | | |A01=Assess appropriateness for clinical condition | {{Family tree | | | | A01 | | | |A01=Assess appropriateness for clinical condition<br>Heart rate typically < 50/min if bradyarrhythima}} | ||
{{Family tree | | | | |!| | | | | }} | {{Family tree | | | | |!| | | | | }} | ||
{{Family tree | | | | B01 | | | |B01=Identify and treat underlying cause | {{Family tree | | | | B01 | | | |B01=Identify and treat underlying cause | ||
* Maintain patent airway; assist breathing as necessary | * Maintain patent airway; assist breathing as necessary | ||
* Oxygen (if hypoxemic) | * Oxygen (if hypoxemic) | ||
* Cardiac monitor to identify rhythm | * Cardiac monitor to identify rhythm | ||
* Monitor blood pressure and oximetry | * Monitor blood pressure and oximetry | ||
* IV access | * IV access | ||
Revision as of 18:02, 22 August 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]: Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]
Definition
Sinus bradycardia is defined as a sinus rhythm with a rate below 60 beats per minute.
Causes
Life Threatening Causes
Life-threatening conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
- Amiodarone
- Amitriptyline
- Beta-blockers
- Cardiac glycosides
- Cardiomyopathy
- Carotid sinus hypersensitivity
- Clonidine
- Diltiazem
- Dronedarone
- Flecainide
- Friedreich ataxia
- Heart transplant
- Hypertensive heart disease
- Hypothermia
- Hypothyroidism
- Ischemic heart disease
- Lithium
- Lyme disease
- Methyldopa
- Obstructive sleep apnea
- Pericarditis
- Phenothiazines
- Procainamide
- Propafenone
- Quinidine
- Reserpine
- Rheumatic fever
- Sepsis
- Trauma
- Vasovagal syncope
- Verapamil
- Viral myocarditis
Management
Figure 1: Management of patients with Bradycardia:[1]
| Assess appropriateness for clinical condition Heart rate typically < 50/min if bradyarrhythima | |||||||||||||||||||
Identify and treat underlying cause
| |||||||||||||||||||
Persistent bradyarhythmia causing:
| |||||||||||||||||||
| Yes | No | ||||||||||||||||||
| Atropine first dose 0.5 mg iv bolus, repeat every 3-5 minutes Maximum: 3 mg If atropine ineffective:Transcutaneous Pacing OR Dopamine infusion (2-10 mcg/kg/min) OR Epinephrine infusion (2-10 mcg/min) | Monitor and observe | ||||||||||||||||||
Algorithm based on the 2010 AHA guidelines for cardiopulmonary resuscitation and emergency cardiovascular care.[1]
Do's
Don'ts
References
- ↑ 1.0 1.1 Neumar, RW.; Otto, CW.; Link, MS.; Kronick, SL.; Shuster, M.; Callaway, CW.; Kudenchuk, PJ.; Ornato, JP.; McNally, B. (2010). "Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S729–67. doi:10.1161/CIRCULATIONAHA.110.970988. PMID 20956224. Unknown parameter
|month=ignored (help)