ACLS: bradycardia - Revision history

Danbot: Add evidence-based Disposition section

2026-03-22T10:03:57Z

Add evidence-based Disposition section

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 **{{MedicationDose|drug=Atropine|dose=2 mg, double q5-30 min until secretions controlled|route=IV|context=Organophosphate toxicity|indication=ACLS: Bradycardia|population=Adult}}
 **{{MedicationDose|drug=Pralidoxime|dose=1-2 g over 15-30 min|route=IV|context=Organophosphate toxicity|indication=ACLS: Bradycardia|population=Adult}}
 ==See Also==

Danbot: Strip excess bold text

2026-03-22T09:23:58Z

Strip excess bold text

← Older revision		Revision as of 09:23, 22 March 2026
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	==Categories==		==Categories==
	*~~'''~~Sinus node dysfunction~~'''~~		*Sinus node dysfunction
	**[[Sinus bradycardia]]		**[[Sinus bradycardia]]
	**[[Sinus arrest]]		**[[Sinus arrest]]
	**[[Tachy-Brady Syndrome]] ([[Sick Sinus]])		**[[Tachy-Brady Syndrome]] ([[Sick Sinus]])
	**Chronotropic incompetence		**Chronotropic incompetence
	*~~'''~~[[AV node dysfunction]]~~'''~~		*[[AV node dysfunction]]
	**[[1st degree AV block]]		**[[1st degree AV block]]
	**[[2nd degree AV block type I (Wenkebach)]]		**[[2nd degree AV block type I (Wenkebach)]]
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	==Management==		==Management==
	[[File:ACLS-bradycardia.png\|thumb\|Algorithm for bradycardia with a pulse (Adapted from ACLS 2010)]]		[[File:ACLS-bradycardia.png\|thumb\|Algorithm for bradycardia with a pulse (Adapted from ACLS 2010)]]
	*~~'''~~[[Atropine]]~~'''~~		*[[Atropine]]
	**Can be used as temporizing measure (while awaiting pacing and/or chronotropes)		**Can be used as temporizing measure (while awaiting pacing and/or chronotropes)
	**Use cautiously in patients with ongoing ischemia (tachycardia may worsen ischemia)		**Use cautiously in patients with ongoing ischemia (tachycardia may worsen ischemia)
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	***Priority is to use external cardiac pacemaking<ref>Burns, E. AV block: 3rd degree (complete heart block). http://lifeinthefastlane.com/ecg-library/basics/complete-heart-block/</ref>		***Priority is to use external cardiac pacemaking<ref>Burns, E. AV block: 3rd degree (complete heart block). http://lifeinthefastlane.com/ecg-library/basics/complete-heart-block/</ref>
	***Block is below AV node so atropine will accelerate sinus rate, leading to worsening of block and increased fatigue of AV nodal cells		***Block is below AV node so atropine will accelerate sinus rate, leading to worsening of block and increased fatigue of AV nodal cells
	*~~'''~~Chronotropes~~'''~~		*Chronotropes
	**{{MedicationDose\|drug=Dopamine\|dose=5-20 mcg/kg/min\|route=IV drip\|context=Chronotrope for bradycardia\|indication=ACLS: Bradycardia\|population=Adult}}		**{{MedicationDose\|drug=Dopamine\|dose=5-20 mcg/kg/min\|route=IV drip\|context=Chronotrope for bradycardia\|indication=ACLS: Bradycardia\|population=Adult}}
	**{{MedicationDose\|drug=Dobutamine\|dose=2-20 mcg/kg/min\|route=IV drip\|context=Chronotrope for bradycardia\|indication=ACLS: Bradycardia\|population=Adult}}		**{{MedicationDose\|drug=Dobutamine\|dose=2-20 mcg/kg/min\|route=IV drip\|context=Chronotrope for bradycardia\|indication=ACLS: Bradycardia\|population=Adult}}
	**{{MedicationDose\|drug=Epinephrine\|dose=2-10 mcg/min (0.03-0.2 mcg/kg/min)\|route=IV drip\|context=Chronotrope for bradycardia\|indication=ACLS: Bradycardia\|population=Adult}}		**{{MedicationDose\|drug=Epinephrine\|dose=2-10 mcg/min (0.03-0.2 mcg/kg/min)\|route=IV drip\|context=Chronotrope for bradycardia\|indication=ACLS: Bradycardia\|population=Adult}}
	**{{MedicationDose\|drug=Isoproterenol\|dose=2-10 mcg/min\|route=IV drip\|context=Chronotrope for bradycardia\|indication=ACLS: Bradycardia\|population=Adult}}		**{{MedicationDose\|drug=Isoproterenol\|dose=2-10 mcg/min\|route=IV drip\|context=Chronotrope for bradycardia\|indication=ACLS: Bradycardia\|population=Adult}}
	*~~'''~~[[Transcutaneous Pacing]]~~'''~~		*[[Transcutaneous Pacing]]
	*~~'''~~[[Transvenous Pacing]]~~'''~~		*[[Transvenous Pacing]]

	===[[Antidotes]] for toxicologic causes===		===[[Antidotes]] for toxicologic causes===

Danbot: Danbot moved page ACLS: Bradycardia to ACLS: bradycardia: Naming convention: first word capitalized, subsequent words lowercase

2026-03-22T02:37:48Z

Danbot moved page ACLS: Bradycardia to ACLS: bradycardia: Naming convention: first word capitalized, subsequent words lowercase

← Older revision	Revision as of 02:37, 22 March 2026
(No difference)

Danbot: Convert medications to MedicationDose template with SMW; dosing verified against AHA 2020

2026-03-20T15:53:44Z

Convert medications to MedicationDose template with SMW; dosing verified against AHA 2020

← Older revision		Revision as of 15:53, 20 March 2026
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	**Use cautiously in patients with ongoing ischemia (tachycardia may worsen ischemia)		**Use cautiously in patients with ongoing ischemia (tachycardia may worsen ischemia)
	**Avoid and/or do not rely on in wide complex bradycardia, especially in setting of ischemia<ref>Neumar RW et al. Part 8: Adult Advanced Cardiovascular Life Support. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.</ref>		**Avoid and/or do not rely on in wide complex bradycardia, especially in setting of ischemia<ref>Neumar RW et al. Part 8: Adult Advanced Cardiovascular Life Support. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.</ref>
	**~~1mg~~ q3-~~5min (max 3mg or~~ 3 ~~doses)~~		**{{MedicationDose\|drug=Atropine\|dose=1 mg q3-5 min\|route=IV\|context=Symptomatic bradycardia\|indication=ACLS: Bradycardia\|population=Adult\|max_dose=3 mg\|link=no}}
	***May not work in 2nd/3rd degree heart block, heart transplant		***May not work in 2nd/3rd degree heart block, heart transplant
	***Priority is to use external cardiac pacemaking<ref>Burns, E. AV block: 3rd degree (complete heart block). http://lifeinthefastlane.com/ecg-library/basics/complete-heart-block/</ref>		***Priority is to use external cardiac pacemaking<ref>Burns, E. AV block: 3rd degree (complete heart block). http://lifeinthefastlane.com/ecg-library/basics/complete-heart-block/</ref>
	***Block is below AV node so atropine will accelerate sinus rate, leading to worsening of block and increased fatigue of AV nodal cells		***Block is below AV node so atropine will accelerate sinus rate, leading to worsening of block and increased fatigue of AV nodal cells
	*'''Chronotropes'''		*'''Chronotropes'''
	**[[Dopamine]] 5-20 mcg/kg/min~~, max 50 mcg/kg/min~~		**{{MedicationDose\|drug=Dopamine\|dose=5-20 mcg/kg/min\|route=IV drip\|context=Chronotrope for bradycardia\|indication=ACLS: Bradycardia\|population=Adult}}
	**[[Dobutamine]] 2-20 mcg/kg/min~~, max 40 mcg/kg/min~~		**{{MedicationDose\|drug=Dobutamine\|dose=2-20 mcg/kg/min\|route=IV drip\|context=Chronotrope for bradycardia\|indication=ACLS: Bradycardia\|population=Adult}}
	**[[Epinephrine]] 2-10 mcg/min (~0.03-0.2 ~~mcg/kg/min, max 1~~ mcg/kg/min)		**{{MedicationDose\|drug=Epinephrine\|dose=2-10 mcg/min (0.03-0.2 mcg/kg/min)\|route=IV drip\|context=Chronotrope for bradycardia\|indication=ACLS: Bradycardia\|population=Adult}}
	**[[Isoproterenol]] 2-10 mcg/min		**{{MedicationDose\|drug=Isoproterenol\|dose=2-10 mcg/min\|route=IV drip\|context=Chronotrope for bradycardia\|indication=ACLS: Bradycardia\|population=Adult}}
	*'''[[Transcutaneous Pacing]]'''		*'''[[Transcutaneous Pacing]]'''
	*'''[[Transvenous Pacing]]'''		*'''[[Transvenous Pacing]]'''
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	===[[Antidotes]] for toxicologic causes===		===[[Antidotes]] for toxicologic causes===
	*[[Beta-Blocker Toxicity]]		*[[Beta-Blocker Toxicity]]
	**[[Glucagon~~]] 5mg IV Q10min~~ (~~repeat~~ up to 3 doses)		**{{MedicationDose\|drug=Glucagon\|dose=5 mg q10 min (up to 3 doses)\|route=IV\|context=Beta-blocker toxicity antidote\|indication=ACLS: Bradycardia\|population=Adult}}
	**[[Insulin~~]] 1U~~/kg bolus		**{{MedicationDose\|drug=Insulin\|dose=1 U/kg bolus\|route=IV\|context=Beta-blocker toxicity (HDIE)\|indication=ACLS: Bradycardia\|population=Adult}}
	**[[Intralipid]] (ILE)		**[[Intralipid]] (ILE)
	*[[Calcium Channel Blocker Toxicity]]		*[[Calcium Channel Blocker Toxicity]]
	**[[Calcium gluconate~~]] 3g~~		**{{MedicationDose\|drug=Calcium gluconate\|dose=3 g\|route=IV\|context=CCB toxicity antidote\|indication=ACLS: Bradycardia\|population=Adult}}
	**[[Insulin~~]] 1U~~/kg bolus		**{{MedicationDose\|drug=Insulin\|dose=1 U/kg bolus\|route=IV\|context=CCB toxicity (HDIE)\|indication=ACLS: Bradycardia\|population=Adult}}
	**[[Intralipid]] (ILE)		**[[Intralipid]] (ILE)
	*[[Digoxin Toxicity]]		*[[Digoxin Toxicity]]
	**[[Dig immune Fab]] 10-20 vials		**{{MedicationDose\|drug=Dig immune Fab\|dose=10-20 vials\|route=IV\|context=Digoxin toxicity antidote\|indication=ACLS: Bradycardia\|population=Adult}}
	*[[Opioid Toxicity]]		*[[Opioid Toxicity]]
	**[[Naloxone]] 0.~~4mg~~ IV		**{{MedicationDose\|drug=Naloxone\|dose=0.4 mg\|route=IV\|context=Opioid toxicity reversal\|indication=ACLS: Bradycardia\|population=Adult}}
	*[[Organophosphate Toxicity]]		*[[Organophosphate Toxicity]]
	**[[Atropine~~]] 2mg IV~~, double ~~dose~~ q5-~~30m~~ until secretions controlled		**{{MedicationDose\|drug=Atropine\|dose=2 mg, double q5-30 min until secretions controlled\|route=IV\|context=Organophosphate toxicity\|indication=ACLS: Bradycardia\|population=Adult}}
	**[[Pralidoxime]] 1-~~2g IV~~ over 15-~~30min~~		**{{MedicationDose\|drug=Pralidoxime\|dose=1-2 g over 15-30 min\|route=IV\|context=Organophosphate toxicity\|indication=ACLS: Bradycardia\|population=Adult}}

	==See Also==		==See Also==

Rossdonaldson1: /* Categories */

2025-12-10T20:55:10Z

Rossdonaldson1: /* Categories */

2025-12-10T20:51:07Z

Rossdonaldson1: /* Categories */

2025-12-10T20:49:53Z

Rossdonaldson1: /* Video */

2025-12-10T20:17:53Z

Video

← Older revision		Revision as of 20:17, 10 December 2025
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	*[http://ddxof.com/simplified-acls-algorithms/ DDxOf: Simplified ACLS Algorithms]		*[http://ddxof.com/simplified-acls-algorithms/ DDxOf: Simplified ACLS Algorithms]
	*[https://emergencymedicinecases.com/treatment-bradycardia-bradydysrhythmias/ EM Cases Treatment of Bradycardia and Bradydysrhythmias]		*[https://emergencymedicinecases.com/treatment-bradycardia-bradydysrhythmias/ EM Cases Treatment of Bradycardia and Bradydysrhythmias]

	~~==Video==~~

	==References==		==References==

Masoodrm: /* Background */

2025-12-10T18:15:55Z

Background

← Older revision		Revision as of 18:15, 10 December 2025
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	==Background==		==Background==
	*HR < 60		*Heart rate < 60
	*Intervention ~~only necessary~~ if patient is symptomatic (~~CASH gets the JOULES =~~ chest pain, altered mental status, shortness of breath, hypotension)		*Intervention indicated if patient is symptomatic or experiencing symptoms of end organ damage (chest pain, altered mental status, shortness of breath, hypotension)

	==Categories==		==Categories==

Rossdonaldson1: /* Antidotes for toxicologic causes */

2025-04-23T18:10:50Z

Antidotes for toxicologic causes

← Older revision		Revision as of 18:10, 23 April 2025
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	===[[Antidotes]] for toxicologic causes===		===[[Antidotes]] for toxicologic causes===
	*[[Beta-Blocker Toxicity]]		*[[Beta-Blocker Toxicity]]
	**[[Glucagon]] 5mg IV Q10min (~~rpt~~ up to 3 doses)		**[[Glucagon]] 5mg IV Q10min (repeat up to 3 doses)
	**[[Insulin]] 1U/kg bolus		**[[Insulin]] 1U/kg bolus
	**[[Intralipid]] (ILE)		**[[Intralipid]] (ILE)

← Older revision		Revision as of 20:55, 10 December 2025
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	*'''[[AV node dysfunction]]'''		*'''[[AV node dysfunction]]'''
	**[[1st degree AV block]]		**[[1st degree AV block]]
	**2nd degree AV block ~~Mobitz~~ I~~/Wenckebach~~		**[[2nd degree AV block type I (Wenkebach)]]
	**2nd degree AV block ~~Mobitz~~ II		**[[2nd degree AV block type II]]
	**[[3rd degree AV block]] ([[complete heart block]])		**[[3rd degree AV block]] ([[complete heart block]])

← Older revision		Revision as of 20:51, 10 December 2025
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	==Categories==		==Categories==
	*'''Sinus node dysfunction'''		*'''Sinus node dysfunction'''
	**Sinus bradycardia		**[[Sinus bradycardia]]
	**Sinus arrest		**[[Sinus arrest]]
	**[[Tachy-Brady Syndrome]] ([[Sick Sinus]])		**[[Tachy-Brady Syndrome]] ([[Sick Sinus]])
	**Chronotropic incompetence		**Chronotropic incompetence
	*'''[[AV node dysfunction]]'''		*'''[[AV node dysfunction]]'''
	**1st degree AV block		**[[1st degree AV block]]
	**2nd degree AV block Mobitz I/Wenckebach		**2nd degree AV block Mobitz I/Wenckebach
	**2nd degree AV block Mobitz II		**2nd degree AV block Mobitz II
	**3rd degree AV block (complete heart block)		**[[3rd degree AV block]] ([[complete heart block]])

	==Differential Diagnosis==		==Differential Diagnosis==

← Older revision		Revision as of 20:49, 10 December 2025
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	**[[Tachy-Brady Syndrome]] ([[Sick Sinus]])		**[[Tachy-Brady Syndrome]] ([[Sick Sinus]])
	**Chronotropic incompetence		**Chronotropic incompetence
	*'''AV node dysfunction'''		*'''[[AV node dysfunction]]'''
	**1st degree AV block		**1st degree AV block
	**2nd degree AV block Mobitz I/Wenckebach		**2nd degree AV block Mobitz I/Wenckebach