Sandbox/brady

Unstable patient

Stable patient

Continue with the diagnostic approach

Identify and treat underlying cause ❑ Maintain patient airway ❑ Assist breathing if required ❑ Give supplemental oxygen ❑ Monitor blood pressure ❑ Give atropine 0.5 mg IV bolus and repeat every 3-5 mins with a maximum dose of 3 mg

❑ If atropine ineffective administer ❑ Dopamine infusion (2-10 mcg/kg/min) OR ❑ Administer epinephrine infusion (2-10 mcg/min) OR ❑ Proceed with transcutaneous pacing Class IIa, level of evidence B)

If signs of poor perfusion or shock still persist ❑ Consult a cardiologist and ❑ Prepare patient for transvenous pacing