Adult Bradycardia Management (ACLS) — free guideline decision tool
This tool summarizes ACLS management of adult symptomatic bradycardia: atropine first-line, then transcutaneous pacing or dopamine/epinephrine infusion, per AHA 2020.
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Implements the decision logic from published clinical guidelines.
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Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Situation | Well-perfused / no serious symptoms |
|---|
→ACLS bradycardiaObserve and monitor
- Management：Maintain airway/oxygen (if needed), monitor, establish IV access, 12-lead ECG; identify and treat reversible causes (H's & T's, drugs, electrolytes, ischemia)
- Follow-up：No immediate medication needed if no serious symptoms; continue observation, specialist consult if needed
- Basis：AHA ACLS adult bradycardia guideline 2020
| Situation | Mobitz II / third-degree AV block / new wide-QRS escape |
|---|
→ACLS bradycardiaPacing first (atropine usually ineffective)
- Pacing priority：Mobitz II/third-degree block/new wide-QRS escape are infranodal lesions; atropine is usually ineffective → transcutaneous pacing (TCP) as soon as possible, prepare transvenous pacing
- Bridging medication：Before pacing/if ineffective, use dopamine 5–20 μg/kg/min or epinephrine 2–10 μg/min to maintain rate and perfusion
- Consult：Early cardiology/EP consult to evaluate permanent pacing
Common questions
What is Adult Bradycardia Management (ACLS)?
This tool summarizes ACLS management of adult symptomatic bradycardia: atropine first-line, then transcutaneous pacing or dopamine/epinephrine infusion, per AHA 2020.
How is Adult Bradycardia Management (ACLS) calculated? What is the core formula?
Branches: stable (observe, treat reversible causes) → symptomatic (atropine 1 mg q3–5min, max 3 mg → TCP or dopamine 5–20 μg/kg/min or epinephrine 2–10 μg/min) → high-grade block (pacing first, bridging infusions).
When is Adult Bradycardia Management (ACLS) used?
Use to triage bradycardia by severity — observe if well-perfused, escalate to atropine and pacing if symptomatic, and pace first for high-grade (infranodal) block — while always seeking reversible causes.
What are the key clinical points for Adult Bradycardia Management (ACLS)?
Atropine is usually ineffective in Mobitz II, third-degree block, or new wide-QRS escape — pace early rather than delaying with repeated atropine. (original synthesis · not guideline verbatim) Atropine dose is 1 mg every 3–5 minutes to a maximum of 3 mg; a single dose < 0.5 mg can paradoxically slow the rate. Transcutaneous pacing, dopamine infusion, and epinephrine infusion are equivalent second-line options titrated to clinical improvement.
What are the limits and cautions when using Adult Bradycardia Management (ACLS)?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
How is Adult Bradycardia Management (ACLS) calculated in practice? Can you show a worked example?
Inputs: Situation Well-perfused / no serious symptoms → Result: ACLS bradycardia Observe and monitor（Management: Maintain airway/oxygen (if needed), monitor, establish IV access, 12-lead ECG; identify and treat reversible causes (H's & T's, drugs, electrolytes, ischemia), Follow-up: No immediate medication needed if no serious symptoms; continue observation, specialist consult if needed, Basis: AHA ACLS adult bradycardia guideline 2020） Inputs: Situation Mobitz II / third-degree AV block / new wide-QRS escape → Result: ACLS bradycardia Pacing first (atropine usually ineffective)（Pacing priority: Mobitz II/third-degree block/new wide-QRS escape are infranodal lesions; atropine is usually ineffective → transcutaneous pacing (TCP) as soon as possible, prepare transvenous pacing, Bridging medication: Before pacing/if ineffective, use dopamine 5–20 μg/kg/min or epinephrine 2–10 μg/min to maintain rate and perfusion, Consult: Early cardiology/EP consult to evaluate permanent pacing）
Run Adult Bradycardia Management (ACLS) now
This tool summarizes ACLS management of adult symptomatic bradycardia: atropine first-line, then transcutaneous pacing or dopamine/epinephrine infusion, per AHA 2020.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
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