Pediatric Bradycardia Algorithm

Last updated: December 20, 2020

2020 updated guidelines have been published by American Heart Association®, by enrolling in our courses you will receive the current learning materials (2016 guidelines) now and also AUTOMATICALLY have free access to the 2021 guidelines when available. Please note that our company typically implements new training guidelines up to a year before AHA releases their updates.

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  1. If the patient is stable, identify the cause of the bradycardia and treat it.
  2. Complete the basics
    1. Be sure that the airway is patent – do whatever is necessary to maintain a patent airway
    2. Administer oxygen as needed (02 Saturation less than 94% or the presence of shortness of breath)
    3. Apply cardiac monitor
    4. Take and monitor vital signs including pulse oximetry
    5. Obtain IV or IO access
    6. 12 Lead ECG – if available and patient stable (do not delay treatment to acquire)
  3. If signs of perfusion is present proceed with treatment
    1. Hypotension
    2. Acutely altered level of consciousness
    3. Signs of shock
  4. If no signs of perfusion
    1. Support basics (ABCs)
    2. Give oxygen if indicated
    3. Observe
    4. Consider cardiology consultation
  5. Signs of poor perfusion
    1. If HR <60/min with poor perfusion despite 02 and ventilation begin CPR
    2. Administer atropine (0.02mg/kg) if suspected vagal response or if primary AV block maximum single dose of 0.5mg
    3. Administer epinephrine 0.01mg/kg (0.1ml/kg) of 1:10,000 Can be repeated every 3–5 minutes if bradycardia does not resolve
This page is written by on Feb 1, 2017.