Bradycardia

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Question 1 of 3

1. Question
With the ALS treatment algorithm in mind, what is your first management step?
- Administer 500mcg atropine IV.
- Administer 1mg atropine IV.
- Commence transvenous pacing.
- Take a venous blood gas to identify any potential reversible causes for the bradycardia.
- Take a short history to identify any potential reversible causes for the bradycardia.
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Question 2 of 3

2. Question
You identify no reversible causes for the bradycardia. Tracey is normally hypertensive, and has been feeling a bit woozy throughout the day. She has no chest pain, and her observations remain unchanged.

What is the best descriptor of her circumstance?
- All of the below statements are correct.
- Tracey’s blood pressure is lower than you would expect in a patient with hypertension, so she is shocked, and requires treatment.
- Tracey needs further exploration of her symptoms to see if she requires immediate treatment.
- Tracey Is “woozy” so she is syncopal and requires treatment.
- Tracey should be started on immediate oxygen therapy as she is critically unwell.
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Question 3 of 3

3. Question
You decide that Tracey has no reversible causes, and no adverse signs. Her blood tests come back as normal. According to the ALS algorithm, what is the next step?

Here’s her ECG

Fig.1³
- Her ECG shows Type 2 mobitz so she is at risk of asystole and interim measures like atropine, adrenaline, isoprenaline should be considered.
- Her ECG shows Type 2 mobitz, so she can be discharged with urgent outpatient follow up.
- Her ECG shows no long pauses so her CHB is likely to be stable and she can be admitted for observation.
- Her ECG shows a complete heart block with broad QRS, so she is at risk of asystole and interim measures like atropine, adrenaline, isoprenaline should be considered.
- Her ECG is irrelevant as the heart rate is 38 – Tracey needs atropine and cardiology review.
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Bradycardia

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