Scenario: A patient with symptomatic bradycardia is unresponsive to atropine.

Initial Assessment:

• Responsiveness: Decreased level of consciousness.
• Breathing: Adequate.
• Pulse: 30 bpm, regular.
• Blood Pressure: 70/40 mmHg.

Actions:

Atropine 0.5 mg IV has been administered twice with no improvement.

Questions:

1. What are the next steps in managing this patient?

   • a) Administer more atropine (up to a total of 3 mg)
   • b) Initiate transcutaneous pacing or consider dopamine/epinephrine infusion
   • c) Administer amiodarone
   • d) Prepare for defibrillation

2. What is the maximum total dose of atropine recommended?

   • a) 1 mg
   • b) 2 mg
   • c) 3 mg
   • d) 5 mg

3. What is the goal of transcutaneous pacing?

   • a) To increase the heart rate and improve perfusion
   • b) To convert the rhythm to sinus rhythm
   • c) To decrease the heart rate
   • d) To treat underlying causes of bradycardia.

These MMCs cover key aspects of the Bradycardia Algorithm, including:

• Identifying symptomatic bradycardia
• Appropriate medication administration (atropine)
• Next steps if atropine is ineffective (pacing, infusions)