Not all bradycardias were created equal - Winny Li
image by: Fikri El Tahir Abdalla
Key step 1: Temporarily increase the heart rate
This can be done either pharmacologically (using dopamine or epinephrine) or electrically (starting with transcutaneous pacing). In the past, I was confused about the order in which these interventions should be tried. My approach now is simple: start both at the same time. Transcutaneous pacing frequently fails and is not a long term solution, so starting a chronotropic medication right away makes sense. However, it takes time to get a drip started and titrated to effect, so an early attempt at transcutaneous pacing is important. Arranging the team so that both of these interventions are implemented in parallel rather than in series…
In bradycardic patients, immediate and effective management of airway and breathing is essential, because hypoxia is a potential cause of bradycardia.1,2 However, airway management in the setting of cardiogenic shock is fraught with difficulty.
Your Path to Meaningful Connections in the World of Health and Medicine
Connect, Collaborate, and Engage!
Coming Soon - Stitches, the innovative chat app from the creators of HWN. Join meaningful conversations on health and medical topics. Share text, images, and videos seamlessly. Connect directly within HWN's topic pages and articles.