Protocol 2-154 - Bradycardia

CMH EMS & MIH Protocols

EMD:

• No specific protocol.

EMR:

• Calm and reassure patient. Ensure patient does not exert themselves.
• Oxygen to maintain SpO2 between 94-99%.
• Apply Cardiac Monitor limb leads.

• Adult:	Pediatric:
  HR less than 60: Apply Combo Pads anterior/posterior.	HR less than 80: Apply Combo Pads anterior/posterior. HR less than 50: Ventilate, then initiate chest compressions if ventilation does not raise HR above 60.

EMT:

• Ensure completion of applicable items above.
• Consider assisting ALS with Capnography .

AEMT:

• Ensure completion of applicable items above.
• IV NS/LR.

RN:

• Ensure completion of all applicable items above.
• Obtain 12-Lead ECG.
• Consider IO NS/LR. Do not delay for IV/IO if symptomatic.
• Contact MEDICAL CONTROL if Hypothermia patient.

• Adult: Rate less than 50 and symptomatic:

  Pediatric: Rate less than 60 and symptomatic:

  Unstable: Consider Pacing Consider Pain Control Stable: Atropine 1 mg IV/IO. Repeat every 3-5 min (max 3 mg). Consider Epinephrine 1:10,000 0.02-0.2 mcg/kg/min titrated to MAP greater than 65. Click "calculate" to get dose. Consider Dopamine 5-20 mcg/kg/min IV/IO. Click "calculate" to get dose. Consider Epinephrine 1:10,000 2-10 mcg/min IV/IO: Mix 1 mg in 100 ml NS/LR. 2 mcg/min = 12 ml/hr. 10 mcg/min = 60 ml/hr.

  Consider Epinephrine 1:10,000 0.01 mg/kg IV/IO repeat every 3-5 min. Click "calculate" to get dose. Consider Atropine 0.02 mg/kg IV/IO may repeat once (min 0.1 mg) (max 0.5 mg). Click "calculate" to get dose. Consider Pacing at age appropriate rate: 0-1 yr old: 2-3 yr old: 4-5 yr old: 6-9 yr old: 10-16 yr old: 135 BPM 130 BPM 105 BPM 90 BPM 80 BPM Consider Pain Control

• Consider and correct treatable causes: Hypovolemia, hypoxia, hypo/hyperkalemia, hypothermia, hypoglycemia, acidosis, tension pneumothorax, toxins, thrombosis, and cardiac tamponade.

Medic:

• Ensure completion of all applicable items above.

CP:

• Ensure completion of all applicable items above.

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Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.