ACLS review: Bradycardia part 8

Hypokalemia

·         Slow rhythm with ST segment depression, flattened waves, prominent U wave

·         Potassium replacement either orally or IV

·         No IV push boluses!

Tablets

·         Assess for drug overdose

·         Assess for hx of drug use

·         Consult poison control

Tablets: Calcium Channel Blockers

·         Hypotension

·         Bradycardia with variable heart block

·         Altered mental status

·         EKG: slow rate, prolonged PRI, AV blocks

·         Rx Calcium chloride 10% 1-4G slow IV

·         Fluid resuscitation, vasopressor agents, atropine, transvenous pacing

Tablets: Beta blockers

·         Hypotension

·         Bradycardia with variable heart block

·         EKG: slow rate, prolonged PRI

·         Rx Glucagon 3-10mg IV bolus followed by infusion 2-5mg/hr

Tablets: Tricyclic Antidepressants

·         Amitriptyline, Doxepine, Trazadone, Nortriptyline

·         Prolonged QT, Widened QRS

·         3Cs & 1A - Cardiac dysrhythmias, Convulsions, Coma, & Acidosis

·         Rx NaHCO3 bolus or infusions

·         Maintain pH > 7.45

Reviewed 2/28/16