6/11/2020 ACLS Bradycardia Algorithm - ACLS Medical Training

Potential How to Identify Treatments

Cause

Hypovolemia Rapid heart rate and narrow QRS on Infusion of normal saline or Ringer’s
ECG; other symptoms of low volume lactate

Hypoxia Slow heart rate Airway management and effective

oxygenation

Hydrogen Ion Low amplitude QRS on the ECG Hyperventilation; consider sodium
Excess (Acidosis) bicarbonate bolus

Hypoglycemia Bedside glucose testing IV bolus of dextrose

Hypokalemia Flat T waves and appearance of a U IV Magnesium infusion

wave on the ECG

Hyperkalemia Peaked T waves and wide QRS Consider calcium chloride, sodium
complex on the ECG bicarbonate, and an insulin and
glucose protocol

Hypothermia Typically preceded by exposure to a Gradual rewarming

cold environment

Tension Slow heart rate and narrow QRS Thoracostomy or needle

Pneumothorax complexes on the ECG; difficulty decompression
breathing

Tamponade – Rapid heart rate and narrow QRS Pericardiocentesis

Cardiac complexes on the ECG

Toxins Typically will be seen as a Based on the specific toxin

prolonged QT interval on the ECG;
may see neurological symptoms

Thrombosis Rapid heart rate with narrow QRS Surgical embolectomy or administration
(pulmonary complexes on the ECG of fibrinolytics
embolus)

Thrombosis ECG will be abnormal based on the Dependent on extent and age of MI
(myocardial location of the infarction
infarction)

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