If atropine is NOT effective, which intervention is used to maintain heart rate and blood pressure?

If atropine is NOT effective, which intervention is used to maintain heart rate and blood pressure?

• A. Push-dose Epinephrine 10 mcg IV/IO, may repeat q2-5 mins
• B. Atropine 1 mg
• C. Synchronized Cardioversion
• D. Defibrillation

Answer: (A)

In symptomatic bradycardia, you first give atropine to increase the heart rate, but if it doesn’t work you need rapid, temporary support to preserve perfusion while preparing longer-term measures. Push-dose epinephrine provides immediate chronotropic and vasopressor effects, quickly raising both heart rate and blood pressure. The small IV/IO bolus of 10 mcg can be repeated every 2–5 minutes as needed, acting as a bridge to transcutaneous pacing or a continuous epinephrine infusion. Epinephrine works by stimulating beta-1 receptors to boost heart rate and contractility, and alpha-1 receptors to raise vascular tone. Other options don’t fit: repeating atropine doesn’t address the failure, synchronized cardioversion targets tachyarrhythmias, and defibrillation is for pulseless arrests like VT/VF, not bradycardia.

In symptomatic bradycardia, you first give atropine to increase the heart rate, but if it doesn’t work you need rapid, temporary support to preserve perfusion while preparing longer-term measures. Push-dose epinephrine provides immediate chronotropic and vasopressor effects, quickly raising both heart rate and blood pressure. The small IV/IO bolus of 10 mcg can be repeated every 2–5 minutes as needed, acting as a bridge to transcutaneous pacing or a continuous epinephrine infusion. Epinephrine works by stimulating beta-1 receptors to boost heart rate and contractility, and alpha-1 receptors to raise vascular tone. Other options don’t fit: repeating atropine doesn’t address the failure, synchronized cardioversion targets tachyarrhythmias, and defibrillation is for pulseless arrests like VT/VF, not bradycardia.