Sinus Bradycardia is a heart rhythm that is organized and originates from the Sinus Atrial (SA)node. However the heart rate is slow. Sinus Brady is known as a heart less than 60 beats per minute (bpm). Using an EKG Strip (6 sec. strip), counting the R points and multiplying by 10 we quickly derive a heart rate of 40 beats per minute, using the strip above. For your AHA ACLS course Bradycardia is applied when a heart rate is less than 50 beats per minute.
Identify:
Heart Rate: less than 50/min
Rhythm: Normal Heart Conduction - slow rate
P wave: present for each QRS
QRS Complex: Normal
ST segment: Normal
Check the Patient:
- Level of Consciousness (Can be fine or Symptomatic)
- Hypotension (Systolic Less than 90mmHg.)
- Chest Discomfort or Shortness of Breath
- Saturation: less than 92%
- HR less than 50/ Bradycardia is present
Initial Steps:
- Consider Oxygenation
- Monitor and Continue Observing
- Obtain IV/IO Access
- Consider Reversible Causes - H's & T's
- Consult Physicians
Determine Stability
Stable Treatment Plan
- Oxygenation
- Drugs
- Atropine 1mg
- Max Dose 3mg
- Reversible Causes
Unstable Treatment Plan
- Pacing
Causes:
- Chest trauma
- Ischemic heart disease
- Acute myocardial infarction
- Acute and chronic coronary artery disease
- Repair of congenital heart disease
- Sick sinus syndrome
- Radiation therapy
- Amyloidosis
- Pericarditis
- Lyme disease
- Rheumatic fever
- Collagen vascular disease
- Myocarditis
- Neuromuscular disorder
- X-linked muscular dystrophy
- Familial disorder
- Inherited channelopathy