Skip to main content

ACLS BRADYCARDIA ALGORITHMS

ACLS Bradycardia Algorithm

Oct 6, 2017
Version control: This document is current with respect to 2015 American Heart Association Guidelines for CPR and ECC. These guidelines are current until they are replaced on October 2020. If you are reading this page after October 2020, please contact ACLS Training Center at support@acls.net for an updated document.

PDF Version

Algorithm download
Order the full set of
printed crash cart cards

Using the ACLS Bradycardia Algorithm for Managing Bradycardia

The ACLS Bradycardia Algorithm outlines the steps for assessing and managing a patient who presents with symptomatic bradycardia. It begins with the decision that the patient's heart rate is < 60 bpm and that is the reason for the patient’s symptoms.

Steps

  1. Decision: Heart rate is < 60 bpm and is symptomatic.
  2. Assess and manage the patient using the primary and secondary surveys:
    • Maintain patent airway.
    • Assist breathing as needed.
    • Administer oxygen if oxygen saturation is less than 94% or the patient is short of breath
    • Monitor blood pressure and heart rate.
    • Obtain a 12-lead ECG.
    • Review patient's rhythm.
    • Establish IV access.
    • Complete a problem-focused history and physical exam.
    • Search and treat possible contributing factors.
  3. Answer two questions to help you decide if the patient's signs and symptoms of poor perfusion are caused by the bradycardia (see Figure 2).
    • Are the signs or symptoms serious, such as hypotension, pulmonary congestion, dizziness, shock, ongoing chest pain, shortness of breath, congestive heart failure, weakness or fatigue, or acute altered mental status?
    • Are the signs and symptoms related to the slow heart rate?
  4. There may be another reason for the patient’s symptoms other than the slow heart rate.
  5. Decide whether the patient has adequate perfusion. The treatment sequence is determined by the severity of the patient's clinical presentation.
    • If perfusion is adequate, monitor and observe the patient.
    • If perfusion is poor, move quickly through the following actions:
      • Prepare for transcutaneous pacing. Do not delay pacing. If no IV is present pacing can be first.
      • Consider administering atropine 0.5 mg IV if IV access is available. This may be repeated every 3 to 5 minutes up to 3mg or 6 doses.
      • If the atropine is ineffective, begin pacing.
      • Consider epinephrine or dopamine while waiting for the pacer or if pacing is ineffective.
        • Epinephrine 2 to 10 µg/min
        • Dopamine 2 to 10 µg/kg per minute
Progress quickly through these actions as the patient could be in pre-cardiac arrest and need multiple interventions done in rapid succession: pacing, IV atropine, and infusion of dopamine or epinephrine.

Comments

Post a Comment

Popular posts from this blog

BASIC LIFE SUPPORT FOR INFANT

PHRONESIS MEDICARE INTERNATIONAL BLS overview for infant Basic life support (BLS) is a basic level of medical care used to help sustain a person who is experiencing cardiac arrest or respiratory failure, until they can be given full medical care by an advanced responder. BLS can be used in any scenario where breathing or heartbeat has been compromised, such as drowning, heart attack, or severe shock (eg, severe loss of blood). BLS is more comprehensive than CPR alone, since it covers additional steps that are not expected from a layperson, as well as techniques for working with other rescuers. The techniques used for BLS vary slightly depending on whether the victim is an adult, child, or infant. This module explains the techniques and procedure for performing BLS on an infant. The adult and child procedures are covered in separate modules. Note: The term 'infant' in this context refers to neonates outside the delivery room setting, up to 12 months old. Children 12...
Post a Comment
Read more

Nigerian paramedics engaging on BLS training with CCTV Personnel

CPR and Basic Life Support (BLS) CPR and Basic Life Support (BLS) training is required of many health-care professionals and lay rescuers to help revive, resuscitate, or sustain a person who is experiencing cardiac arrest or respiratory failure.  Sudden cardiac arrest is the leading cause of death in adults and 88% of all cardiac arrest happen in people’s homes. Providing CPR can double a person’s chance of survival....... 
Post a Comment
Read more

Nigeria Paramedics managing a victim of carbon monoxide poison

Carbon monoxide is a poisonous gas that has no smell or taste. Breathing it in can make you unwell, and it can kill if you're exposed to high levels. Every year there are around 25 deaths from accidental carbon monoxide poisoning in England and Wales. After carbon monoxide is breathed in, it enters your bloodstream and mixes with haemoglobin (the part of red blood cells that carry oxygen around your body), to form carboxyhaemoglobin. When this happens, the blood is no longer able to carry oxygen, and this lack of oxygen causes the body’s cells and tissue to fail and die. Symptoms of carbon monoxide poisoning The symptoms of carbon monoxide poisoning aren't always obvious, particularly during low-level exposure. A  tension-type headache  is the most common symptom of mild carbon monoxide poisoning. Other symptoms include: dizziness nausea (feeling sick) and vomiting tiredness and confusion stomach pain shortness of breath  and d...
Post a Comment
Read more