Bradycardia Flashcards

A patient presents with a heart rate of 38 bpm, hypotension, and altered mental status. Which drug is the FIRST-LINE treatment for symptomatic bradycardia?

Answer: Atropine

Atropine 1 mg IV is the first-line drug for symptomatic bradycardia in ACLS guidelines.

What is the maximum cumulative dose of atropine recommended in ACLS for bradycardia?

Answer: 3 mg

The maximum cumulative dose of atropine is 3 mg (given as repeated 1 mg doses every 3–5 minutes).

A patient with symptomatic bradycardia fails to respond to atropine. Which of the following is the NEXT best step?

Answer: Begin transcutaneous pacing

Transcutaneous pacing is the recommended intervention when atropine fails to improve symptomatic bradycardia.

Which rhythm is most likely to be UNRESPONSIVE to atropine therapy?

Answer: Third-degree AV block with wide QRS escape

Complete heart block with a wide-complex (ventricular) escape rhythm is below the AV node and does not respond to atropine.

During transcutaneous pacing for bradycardia, what confirms electrical capture?

Answer: Widened QRS complexes after each pacing spike with a pulse

Electrical capture is confirmed by a pacing spike followed by a wide QRS, and mechanical capture is confirmed by a palpable pulse.

An ACLS provider considers dopamine infusion for a bradycardic patient. What is the correct dose range for dopamine when used for rate support?

Answer: 2–10 mcg/kg/min

Dopamine at 2–10 mcg/kg/min provides chronotropic and inotropic effects useful in symptomatic bradycardia.

A patient with bradycardia has no symptoms — normal blood pressure, no chest pain, no altered mentation. What is the appropriate ACLS action?

Answer: Observe and monitor; no immediate intervention required

Asymptomatic bradycardia does not require treatment; ACLS intervention is indicated only when signs or symptoms are present.