Ep 155 Treatment of Bradycardia and Bradydysrhythmias
Apr 20, 2021
Join electrophysiologist Paul Dorian, an expert in cardiac rhythms, and emergency medicine physician Tarlan Hedayati as they dive into the nitty-gritty of treating bradycardia. They tackle the critical decision-making process between pacing and medications, discussing when atropine can backfire. Special conditions like hypothermia and AV nodal blocker overdose are examined, revealing unique treatment challenges. Packed with insights and practical tips, this discussion offers vital strategies for managing heart rhythms in emergency situations.
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Kitchen Sink Approach for Bradycardia
- In crashing bradycardia patients, administer calcium for potential hyperkalemia or hypocalcemia.
- Consider glucagon for beta-blocker overdose as a last resort.
Effects of Isoproterenol
- Isoproterenol increases sinus node rate and contractility, but may cause vasodilation.
- It's not ideal when vasoconstriction is needed.
Transcutaneous Pacing Pitfalls
- Initiate transcutaneous pacing early in unstable bradycardia, avoid delay.
- Confirm mechanical capture by correlating electrical activity with pulse oximetry, bedside echo, or femoral pulse.