Bradycardia

Causes:

• • Drugs (BB, CCB, digoxin, amiodarone, sotalol)

  • Cardiac (SS, AMI particularly inferior wall MI, vasovagal attack)

  • Hypothyroidism, healthy young atheletes, ICP in association with HTN

Orders:

• • Hypotensive (SBP <90) start NS 250 - 500 mL IV bolus, place Pt in Trendelenburg position

  • Stat ECG and rhythm strip and cardiac monitoring

  • Cardiac arrest cart

  • HR <40 bpm, get atropine 0.5 mg IV q5 min, not to exceed a total dose of 0.04 mg/kg (max 3 mg).

  • If no imporvement transfer to MICU.

  • Dopamine 2 - 10 mcg/kg/min infusion through central line, or epinephrine 2 - 10 mcg/min infusion through central line.

  • TCP or transvenous pacemaker placement.