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Maha says
That’s correct!
*Transcutaneous pacing* serves as a temporary bridge to stabilize the patient’s heart rate until a more permanent solution, such as a *transvenous pacemaker*, can be implanted.
Source: American Heart Association (AHA) Advanced Cardiovascular Life Support (ACLS) guidelines.
Transcutaneous pacing provides immediate, temporary pacing support, while transvenous pacing or permanent pacemaker implantation offers long-term management.
Maha says
For bradycardia treatment with dopamine:
– Initial dose: 2-5 mcg/kg/min IV
– Titrate to desired response, typically up to 20 mcg/kg/min
Source: American Heart Association (AHA) Advanced Cardiovascular Life Support (ACLS) guidelines.
Essentially titrate up to 10 mcg/kg/min after that it is more of vasoconstriction. Adding low dose epinephrine maybe a good idea and titrate that up.
Dopamine’s dose-dependent effects:
– Low dose (2-5 mcg/kg/min): Increased heart rate
– Higher doses: Increased blood pressure and cardiac contractility
Jeckson Mureri says
“Atropine dose of less than 0.5mg can worsen the bradycardia where as high doses can cause tachycardia”, now that the new dose for Atropine was changed from 0.5 to 1mg every 3 to 5 mins, how much does is high enough to cause tachycardia, initially they were referring to anything more than 0.5mg.
Reference Questions 6
ACLS says
The literature still states that 0.5 mg and lower they have a paradoxical effect and cause bradycardia. There is no change with regard to this fact. I imagine that your next question will probably be, “why did the American Heart Association change the dose to 1 mg.” I have not been able to find A good answer to that question.
Kind regards,
Jeff
Jane says
The question said if TCP is INEFFECTIVE then what is the next step
Jane says
SORRY misread transvenous pacing
ACLS says
The next step would be to initiate chemical pacing using Epinephrine or Dopamine. Kind regards, Jeff
David says
question #10 your quiz says atropine dose is 1 mg.
The correct answer is .5 mg
ACLS says
The new guidelines have adjusted the single atropine dose to 1mg rather than 0.5mg. The Max. cumulative dose remains 3mg. Kind regards, Jeff
steveahm@comcast.net says
Jeff – Please clarify the following: question #10 Brady Quiz #3. Correct answer per site for correct dose of Atropine for brady algorithm = 1.0 mgm IVP and may repeat x 3: yet, both the bradycardia algorithm in the manual and the drug reference at the end of the manual, stipulate the correct dose is Atropine is 0.5 mgm IVP MR repeat x 3. I know in practice I frequently see either 0.5 mgm 0R 1.0 mgm ordered. I find this discreption problematic as it could be a precursor for error. Please clarify the rationale for the correct answer. Many thanks and kudos to you and your team for this remarkable reference site!
ACLS says
I think you may have caught those pages right in the middle of when I was doing my editing for the new guidelines.
The bradycardia section of the website is now completely up-to-date for the new guidelines.
My apologies for any inconvenience or discrepancy that you ran into.
Kind regards,
Jeff