Great talk by Dr @HedayatiMD on all things bradycardia with plenty of pearls 💎
✅Approach to bradycardia: Stable vs not stable, Sinus vs not sinus (look for p waves, is every QRS preceded by p), Narrow vs wide complex
More pearls 👇🏼
#FOAMed #EmergencyMedicine
✅Approach to bradycardia: Stable vs not stable, Sinus vs not sinus (look for p waves, is every QRS preceded by p), Narrow vs wide complex
More pearls 👇🏼
#FOAMed #EmergencyMedicine
💎Pearl #1: 1st degree & 2nd degree type 1: normal variant UNLESS new or symptomatic from it
💎Pearl #2: 2nd degree type 2 and 3rd degree: always abnormal
#FOAMed #EmergencyMedicine
💎Pearl #2: 2nd degree type 2 and 3rd degree: always abnormal
#FOAMed #EmergencyMedicine
💎Pearl #3: Bradycardia + ACS = scary 😱
🔺Inferior OMI: Typically narrow complex, transient bradycardia. Responsive to atropine since likely 2/2 vagal response
🔺Anterior OMI: wide QRS, severe bradycardia caused by ischemia that will not respond to atropine, need TV pacing⚡️
🔺Inferior OMI: Typically narrow complex, transient bradycardia. Responsive to atropine since likely 2/2 vagal response
🔺Anterior OMI: wide QRS, severe bradycardia caused by ischemia that will not respond to atropine, need TV pacing⚡️
💎Pearl #4: Bradycardia + deep T Wave + disproportionate altered mental status ➡️ don’t reflexively blame bradycardia
❗️Think ICH/SAH or tox as cause of AMS
💀Tox causes of bradycardia: the “Brady Bunch” ➡️ BB, CCB, Clonidine, Digoxin
#FOAMed #EmergencyMedicine
❗️Think ICH/SAH or tox as cause of AMS
💀Tox causes of bradycardia: the “Brady Bunch” ➡️ BB, CCB, Clonidine, Digoxin
#FOAMed #EmergencyMedicine
BRASH:
Bradycardia
Renal Failure: treat hyperK
AV Blockade: pace ⚡️
Shock (more on that next tweet)
Hyperkalemia: give Ca if any suspicion
#FOAMed
Bradycardia
Renal Failure: treat hyperK
AV Blockade: pace ⚡️
Shock (more on that next tweet)
Hyperkalemia: give Ca if any suspicion
#FOAMed
Treatment options for bradycardia:
🔺Atropine 0.5-1mg, start with 1mg, acts on AV node
🔺Epinephrine drip (2-10) to treat bradycardia & hypotension (don’t forget push dose epi)
🔺Dopamine also an option, usually readily available in pyxis/crash cart
🔺Transvenous pacing ⚡️
🔺Atropine 0.5-1mg, start with 1mg, acts on AV node
🔺Epinephrine drip (2-10) to treat bradycardia & hypotension (don’t forget push dose epi)
🔺Dopamine also an option, usually readily available in pyxis/crash cart
🔺Transvenous pacing ⚡️
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