ACLS Bradycardia Quiz #2 focuses on the bradycardia algorithm of the ACLS Protocol.
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Question 1 of 10
1. Question
The correct dose of dopamine given in the bradycardia algorithm is:
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Question 2 of 10
2. Question
The key clinical question when determining steps to take for the patient with symptomatic bradycardia is:
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Question 3 of 10
3. Question
The treatment sequence for bradycardia with poor perfusion is:
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Question 4 of 10
4. Question
Transcutaneous pacing should be started immediately if:
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Question 5 of 10
5. Question
If transcutaneous pacing is ineffective for symptomatic bradycardia, the next step would be to prepare for:
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Question 6 of 10
6. Question
(True or False)
Atropine doses of less than 0.5mg may paradoxically result in further slowing of the heart rate.CorrectIncorrect -
Question 7 of 10
7. Question
For bradycardia unresponsive to atropine, what other drug should be considered?
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Question 8 of 10
8. Question
If atropine fails, the treatment of choice for symptomatic bradycardia with signs of poor perfusion is ____________.
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Question 9 of 10
9. Question
The correct dose of epinephrine given in the bradycardia algorithm is:
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Question 10 of 10
10. Question
The correct dose of atropine given in the bradycardia algorithm is:
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Msrikureja says
Q8:
TCP is a treatment that will bridge to the IV pacing, which is the treatment of choice if this is a cardiac center.
ACLS says
American heart Association recommendations place transcutaneous pacing as the treatment of choice in emergent settings because of its use of application. Kind regards, Jeff
Yvonne Wilson says
Jeff, you’re a miracle worker. Thanks for helping me really “lock in” these concepts with great resources and explanations. I realized I had relied too heavily on rote memorization for most of these years, but your work finally made everything crystal clear. Thank you for all you do!
ACLS says
Hi Yvonne,
That’s great! Thanks so much for your comment! I’m so glad that the site has been so helpful for you.
Kind regards, Jeff
Donna Prothro says
This is a great study aide. I will recommend to all my coworkers. Thanks
Donna Prothro, RN
ACLS says
Hi Donna,
You’re very welcome. And thank you for passing the site along to others.
Kind regards, Jeff
Roberta Armstrong says
how is tranvenous pacing accomplished
Jeff with admin. says
This is a basic article about Transvenous Pacing
Kind regards,
Jeff
Roberta Armstrong says
give an example of epi and dopamine gtt calculations please
Jeff with admin. says
The standard concentration for a dopamine drip is 800mg in 500 ml D5W or 1600 mcg/ ml. Dopamine infusion is a weight based infusion so you would need to calculate the infusion rate. For bradycardia, you will infuse at 2 to 10 mcg/kg/min and titrate based on the patient’s response.
Here is the formula for calculating the infusion rate:
Ordered dose x patient weight in kilograms x 60 minutes divided by the solution concentration.
So here is an example:
The patient weighs 50 kg and you want to infuse the drip at at 6 mcg/kg/min then you would calculate it as follows:
6 mcg x 50 kg x 60 minutes divided by 1600 mcg/ml = 11.25 ml/hr
The standard concentration for an epinephrine drip is 3mg in 250 ml D5W or 3000 mcg/250 ml = 12 mcg/ml. So if you want your epinephrine infusion to run at 6 mcg/min then you would calculate it as follows. First, to simplify the drip calculation for any drug ordered as mcg/minute calculate the infusion rate for 1 mcg/minute of 3000 mcg/250 ml solution (12 mcg/ml) as shown here:
1 mcg x 60 min
———————— = 5 ml/hour (infusion rate)
12 mcg/ml (drug concentration)
Once you’ve calculated the infusion rate for 1 mcg/min which is 5 ml/hour, you can
easily determine the titration rates, as shown below:
2 mcg x 5 = 10 ml/hour (2 mcg/minute)
3 mcg x 5 = 15 ml/hour (3 mcg/minute)
4 mcg x 5 = 20 ml/hour (4 mcg/minute)
5 mcg x 5 = 25 ml/hour (5 mcg/minute)
Kind regards,
Jeff
Roberta Armstrong says
I recall three different answers to using epi for brady 1. epi 2-10 mcg/kg and 2-10 mcg /min. and 2-20 mcg/min what is correct?
Jeff with admin. says
Correct dosing for epinephrine within the bradycardia algorithm is 2-10 micrograms/min.
Bradycardia Algorithm
Roberta Armstrong says
please explain mobitz 1 and 2 3rd degree explain tx
Jeff with admin. says
All of these bradycardia heart blocks are reviewed within the bradycardia algorithm review in the interactive coruscate. You can find it here:
Interactive course guide bradycardia algorithm review
Kind regards,
Jeff
Andres says
Isn’t symptomatic bradycardia by definition a bradycardia that causes symptoms directly related to the bradycardia itself? pg 122 on the manual I think. If so, then, wouldn’t option 3 be irrelevant? Thanks for all the great resources!
Jeff with admin. says
There are times when a patient might have bradycardia and the symptoms are not caused by the bradycardia. Here is an example. A 45 year old male with a heart rate of 40 bpm is having chest pain and is short of breath. These symptoms may or may not be related to the bradycardia. The cause of the symptoms should be determined before the treatment is provided.
Kind regards,
Jeff
Tehetena Zarou says
Thank you for such an amazing website!
Jeff with admin. says
You’re welcome! Kind regards, Jeff
Dr Janet j says
It is very useful for everyone appearing for ACLS condition God bless you.
Daba George Warmate says
Thanks Jeff for the differentiation on trans VENOUS and transcutaneous pacing
Rosali Elizabeth says
Informative discussions. Great indeed.
Roberta Choban says
Question 7 if transcutaneous pacing is ineffective you have the the answer as prepare for transcutaneous pacing? Please explain???
Jeff with admin. says
The answer was “prepare for transVENOUS pacing.” TransVENOUS pacing is used when transcutaneous pacing is ineffective.
With transCUTANEOUS pacing, pacer patches are placed on the exterior skin surface. And the electrical impulse is delivered through all of the tissue. There can be a high degree of electrical impedance.
TransVENOUS pacing is when intravenous guide wire delivers electrical impulses directly into the venous system. The transmission of the electrical impulse for transVENOUSpacing is much more effective than transCUTANEOUS pacing.
Kind Regards, Jeff
jamieringel says
The last question asks what would be the first-line treatment for symptomatic bradycardia. Is it not atropine and THEN TCP? Isn’t atropine tried first unless you’re dealing with 2nd degree Type II or 3rd degree heart block?
Jeff with admin. says
The question reads: “The treatment of choice for symptomatic bradycardia with signs of poor perfusion is ___________?”
Atropine would be the drug of choice, however, if signs of poor perfusion is present, TCP becomes the treatment of choice and should not be delayed.
AHA ACLS Manual pg. 126 Transcutaneous pacing should not be delayed for patients who are unstable due to a slow heart rate. It is noninvasive and has a high rate of success for improving the clinical condition of patients with symptomatic bradycardia.
Kind regards, Jeff
JUDITHGRAHAM says
WOULD A DNR NOT BE THE PRIMARY CONSIDERATION?
Jeff with admin. says
With regard to a patient with symptomatic bradycardia, DNR would not be a consideration because the patient is still alive and does not need resuscitation. The patient with symptomatic bradycardia needs increased cardiac output. DNR (do not resuscitate) is only a consideration for the patient that is dead or pulseless and in need of resuscitation.
Kind regards,
Jeff