Category Archives: Symptomatic Bradycardia

Question from an ACP role, For a pediatric patient who has a HR less than 60 with poor signs of perfusion (cyanosis/pale and apneic…..start chest compressions with airway and ventilations via BVM. The question is do we follow it up with epi? In the PALS algorithm it states to do CPR/ventilations, epi, atropine and consider pacing. This is covered under the newborn arrest directive however it is not covered under the adult/pediatric medical cardiac arrest. What does our base hospital want us to? Would it be appropriate to follow the PALS Bradycardia algorithm?

Question: In the Symptomatic Bradycardia Medical Directive, both atropine administration and TCP have hypothermia listed in the contraindications. However, this contraindication is not present for dopamine administration.

This seems to contradict the practice of not giving drugs to the severely hypothermic patient and focusing prehospital care on rapid transport and passive rewarming. Was this omission voluntary and if so, what is the rationale or the studies that support the use of dopamine in such a case? Thank you!

PS: Hypothermia is not listed as a contraindication for dopamine in the ROSC protocol either.

Question: If TCP with Zoll E series, what are the steps to be taken when transferring care to the receiving facility? Procedure to switch to their machine?

Question: On page 2-29 it says "A single dose of atropine should be considered for second degree type II or third degree AV blocks with fluid bolus”. Does that mean fluid bolus for both or just third degree?