European
Resuscitation
Council
Advanced Life Support
www.erc.edu
info@erc.edu
Adverse signs?
* Systolic BP < 90 mmHg
* Heart rate < 40 beats min-1
* Ventricular arrhythmias compromising BP
* Heart failure
Atropine 500 mcg IV
Risk of asystole?
* Recent asystole
* Möbitz II AV block
* Complete heart block with
broad QRS
* Ventricular pause > 3s
Interim measures
* Atropine 500 mcg IV
repeat to maximum of 3 mg
* Adrenaline 2-10 mcg min-1
* Alternative drugs* OR
* Transcutaneous pacing
*Alternatives include:
Aminophylline
Isoprenaline
Dopamine
Glucagon (if beta-blocker or calcium-channel blocker overdose)
Glycopyrronium can be used instead of atropine
Observe
Satisfactory response?
Bradycardia Algorithm
If appropriate, give oxygen, cannulate a vein, and record a 12-lead ECG
NOYES
YES
NO
YES
NO
Seek expert help
Arrange transvenous pacing
Published March 2007 by European Resuscitation Council Secretariat VZW, Drie Eikenstraat 661, 2650 Antwerp, Belgium
Product reference: POSTER-2007-ALSBA_A0-EN Copyright European Resuscitation Council