Emergency Medicine Cases 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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Treating Bradycardia Multifactorially
- Treat bradycardia by addressing its potential causes like ischemia or nitroglycerin toxicity.
- Consider right ventricular infarction-related hypotension, treated with fluids and revascularization.
Managing Bradycardia in STEMI
- For bradycardia during inferior STEMI, prioritize the cath lab, but temporize in the ED.
- Use pacer pads, atropine if necessary, IV fluids, and consider dopamine or epinephrine.
Prioritizing Treatment Modalities
- Prepare pacing and medication simultaneously.
- Start with readily available medications or transcutaneous pacing depending on the patient's condition and available resources.