Student learning toolCreated by: Champsedine Arevalo, MAN, RN, EMT
Normal

Sinus Bradycardia

Sinus rhythm at a rate below 60 bpm.

LEAD II · 25 mm/sSinus Brady

Characteristics

Rate
< 60 bpm
Rhythm
Regular
P wave
Normal, precedes every QRS
QRS
Narrow

Common causes

  • Athletic conditioning
  • Beta-blockers
  • Increased vagal tone
  • Inferior MI
  • Hypothyroidism
  • Hypothermia

ACLS treatment

  1. 1If asymptomatic: monitor.
  2. 2If unstable (hypotension, altered mental status, chest pain, shock): Atropine 1 mg IV every 3–5 min (max 3 mg).
  3. 3If atropine ineffective: transcutaneous pacing, dopamine 5–20 mcg/kg/min, or epinephrine 2–10 mcg/min.

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