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Discussion

Sinus Bradycardia

I am a first year nurse and work night shift. I have had several patients who I had on telemetry be bradycardiac. I get anxious when I am monitoring their telemetry and their heart rate is in the 40s to 50s. So my question is when do you use atropine? What are the symptoms I should be looking for before I use atropine?

Featured Replies

  • Admin

One treats bradycardia when patient is symptomatic. Many individuals are in SB and doesn't necessitate intervention.

s/s where tx may be necessary:

  • syncope
  • shortness of breath
  • chest pain
  • decreased LOC
  • hypotension

Here is a good link about SB:

http://www.emedicine.com/emerg/topic534.htm

  • Admin

You might consider an ACLS course as well as a dysrhythmia and/or ECG course. This will give you a better idea of how to recognize and/or treat individuals like this.

Many pt's become braycardic when asleep,after starting a new cardiac med,post MI. Also atheltic people tend to run in the 40's at rest! I agree with above post re getting into an ACLS course. Symptomatic bradycardia is the key phrase. Ask the more experienced nurses on your shift what the protocol is at your facility. Do not worry, with experience u will feel more comfortable. Good luck and remember asking for help and advice, is always the sign of a nurse who is looking to learn and provide better care for their pt, I commend you!

  • Expert

My DH is bradycardic most of the time, as he has spent most of his life doing physically challenging work. He is in excellent shape. He usually runs high-40s to high-50s. When he gets riled up about something he jumps up to, oh say, 75. :)

If they aren't symptomatic, I wouldn't worry about it. That is one of the few things I remember about clinicals on a telemetry floor.

All of the previous posters have given you good advice, but I would add this: when using PRN orders, go by the guidelines that the MD gives. They usually give parameters for the lowest rate they want the pt experience without Atropine. However, what sirI said about treating the symptoms and assessing the BP, etc. is of utmost importance. Also, always remember to take an apical HR, and don't depend on the monitor. They are a help, but the living breathing nurse is the best help of all!;):nurse:

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