WELD COUNTY EMS PROTOCOLS

ATROPINE SULFATE
PHARMACOLOGY / ACTIONS

• Parasympathetic / Cholinergic blocking agent that:

◊ Increases heart rate.
◊ Increases conduction through the AV node.
◊ Decreases motility & tone to the GI tract.
◊ Decreases action & tone of the urinary bladder.
◊ Dilates pupils.

INDICATIONS:

• Increases heart rate in unstable bradycardia patients.

• To increase conduction in 2nd & 3rd degree blocks & pacemaker failures.
• As an antidote for organophosphate poisonings that exhibit cholinergic reactions.
• Counteract vagal influences in brady systolic & asystolic arrests.
• SLUDGE:
◊ Salivation.
◊ Lacrimation.
◊ Urination.
◊ Defecation.
◊ GI Motility.
◊ Emesis.

CONTRAINDICATIONS:

• Atrial fibrillation.
• Atrial flutter.
• Tachycardias.

PRECAUTIONS:

• Headache, blurred vision, disorientation, & restlessness.

• Tachycardia, palpitations, hypertension.
• Possibility of additive anticholinergic effects with Procainimide & Quinidine.
• Bradycardias in the setting of a myocardial infarction are often a protective mechanism to lower the
hearts demand for oxygen.

Revised: June 2009

Section 506: Atropine Sulfate Page 1 of 2
WELD COUNTY EMS PROTOCOLS
ATROPINE SULFATE
ADULT PROCEDURE:

Asystole / PEA
• 1 mg IVP or IO. Repeat if necessary at 5 to 10 minute intervals to a maximum dose of .04 mg / kg.

Bradycardia
• 0.5 mg IVP or IO

Organophosphate Poisoning
• Generally administered in 1 to 2 mg increments to alleviate life threatening symptoms.
• Use as directed by Base Physician.

Endotracheal Administration
• 2 to 2.5 times the IV dose.

PEDIATRIC PROCEDURE:

Asystole / PEA
• 0.02 mg / kg IVP or IO.
• Minimum dose of 0.1 mg.
• Pediatric bradycardias are primarily caused by hypoxia.

Bradycardia
• Atropine use in pediatric / infant patients is only indicated if the cause of the bradycardia is suspected
to be a vagal response. Epinephrine is the primary medication of choice for bradycardia in the
pediatric / infant patients.
• 0.02 mg / kg IVP or IO.

Endotracheal Administration
• 0.02 mg / kg dosage.

ADMINISTRATION FR EMT - B EMT - IV EMT - I EMT - P

• Administration of Atropine. DO/P SO

Revised: June 2009

Section 506: Atropine Sulfate Page 2 of 2