Module 05
Bradycardia
Recognize symptomatic bradycardia and follow the sequential treatment pathway.
Recognize Symptomatic Bradycardia
- Signs of poor perfusion due to the slow rate:
- — Hypotension
- — Chest pain
- — Altered mental status
- — Shock
Treatment Pathway
1
First-line: Atropine 1 mg IV
Repeat every 3–5 minutes, maximum 3 mg total.
2
If atropine ineffective: Transcutaneous pacing
Prepare for pacing while medication is attempted.
3
Alternative: Dopamine infusion
Beta-1 agonist chronotropic support (5–20 mcg/kg/min).
4
Alternative: Epinephrine infusion
Chronotropic and vasopressor support (2–10 mcg/min).
Clinical Pearl
If the patient is symptomatic from bradycardia, don't delay pacing — start transcutaneous pacing early while pharmacologic alternatives are prepared.
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