atropine for brady

[donedeal]

Has anyone heard of or have in their protocols: give 1mg of atropine to a symptomatic bradycardic patient after an administration of .5mg with no change?

[ptemt]

Mosbys's text says 0.5 mg IVP every 3-5 min for desired response with a max total of 3 mg. It is what they are teaching us for symptomatic bradycardia.

[JakeEMTP]

Yeah, our protocol for symptomatic bradycardia reads 0.5 - 1.0 mg atropine q 5 min to a max. dose of 3 mg. If no change begin pacing. OR dopamine 5mcg/kg/min. while awaiting pacing or ineffective pacing.

[fiznat]

I suppose it makes sense, though if 0.5mg doesn't work, I don't see 1mg making that much of a difference. I think the repeat doses are meant to keep the rate up as the drug metabolizes rather than increase the dosage.

ACLS says we can use dopa or an epi drip as well if the atropine really doesn't work. ...Probably an on-line medcon order for most services.

Anything to avoid pacing conscious alert people who are only mildly symptomatic, I suppose...

[backinboston]

.5 if there alive, 1 if there done (mg of atropine that is)

[ccmedoc]

Has anyone heard of or have in their protocols: give 1mg of atropine to a symptomatic bradycardic patient after an administration of .5mg with no change?

Yep, thats what we use...we have some latitude though and can skip the 0.5 mg part if we believe it necessary.

[firedoc5]

Yep, thats what we use...we have some latitude though and can skip the 0.5 mg part if we believe it necessary.

Ditto

[Dustdevil]

Has anyone heard of or have in their protocols: give 1mg of atropine to a symptomatic bradycardic patient after an administration of .5mg with no change?

Besides Vasopressin, I can't even think of any emergency drugs right off hand that don't allow or call for immediate follow up.

Did somebody tell you that Atropine should not be repeated?

[firespec35]

Besides Vasopressin, I can't even think of any emergency drugs right off hand that don't allow or call for immediate follow up.

Did somebody tell you that Atropine should not be repeated?

It think he's more questioning the dose. Our protocols are .5mg for alive 1mg dead max 3mg.

[TicTok]

I suppose it makes sense, though if 0.5mg doesn't work, I don't see 1mg making that much of a difference. I think the repeat doses are meant to keep the rate up as the drug metabolizes rather than increase the dosage.

ACLS says we can use dopa or an epi drip as well if the atropine really doesn't work. ...Probably an on-line medcon order for most services.

Anything to avoid pacing conscious alert people who are only mildly symptomatic, I suppose...

We start with 0.5mg and repeat 0.5-1mg to a max of 3mg(0.04mg/kg) post ruling out precautions ie, certain AV blocks. Repeating the dose is to put the pt into therapeutic range. Neither atropine or pacing should be used for the "conscious alert people who are only mildly symptomatic". Remember once it is in, it is in and a SVT is as bad as brady dysrhythmia. But these are our protocols.

You keep well.