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Video Demonstration
Bradycardia
First degree AV block is when the PR interval is prolonged (> 0.20 seconds).
2nd Degree AV block type I (Wenckebach-Mobitz I) is when the PR interval becomes increasingly prolonged, R-R intervals are shortened, and a beat (QRS) finally drops
2nd degree AV block Type II (Mobitz II) is when there is no change in the PR interval and than a beat will drop.
Use Atropine as the first-line therapy for Bradycardia
If atropine does not work:
Transcutaneous pacing is crucial to obtain a normal heart rate again if the patient is showing poor perfusion. Even though atropine is the first line treatment for bradycardia, if the patient has severe symptoms of bradycardia or is crashing then it is critical to start Transcutaneous pacing (TCP).
Start TCP right away if the patient:
Once the TCP has started ensure that the heart is getting proper electrical shocks from the pacer. Give analgesics and sedatives to help with pain especially in patients who are alert and awake (might be best to give it before the TCP starts). Make sure to continuously monitor the patient to check if there are any improvements.
REMEMBER: If TCP is ineffective, start infusion of dopamine or epinephrine and get the patient ready for transvenous pacing. Make sure to get professional consultation.
Learning Outcomes:
You have completed Chapter X. Now you should be able to:
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