Bradycardia - ACLS Review
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This next lesson in the series we move on to talk about our Bradycardia Algorithm based on guidelines from the American Heart Association. This is another vital algorithm for you to cement in your memory and be able to act quickly upon, especially for the unstable patient.
**Full disclosure that this video is NOT associated with the American Heart Association (AHA) and is merely a review of the information provided in their guidelines. Additional resources can be found at: cpr.heart.org/en/resuscitatio...
0:00 Intro
1:43 Bradycardia
2:07 Algorithm
3:11 Underlying Causes
3:55 Assess Patient Condition
4:55 Atropine
6:03 Electrically Pace
7:03 Chemically Pace
8:47 Review
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Check out these other great lessons and series of lessons below!
✅ Hemodynamics: • Hemodynamic Principals
✅ Shock: • Shock
✅ ECG/EKG Rhythm Interpretation: • ECG/EKG Interpretation
✅ ICU Drips: • ICU Drips
✅ ECMO: • ECMO
✅ CRRT: • CRRT Explained!
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Where would we be without your service/ lectures? Thank you ever so much!!!
@ICUAdvantage
3 жыл бұрын
Love this! So happy to hear you like them. Thank you!
@cnwachuk3141
2 жыл бұрын
We would read
So happy I came across these videos while reviewing for my ACLS course! You do an excellent job making the content easily understandable, I definitely feel better prepared after watching them. Thank you!
God, please continue to bless Mr.Eddie. I needed this lecture ❤️❤️❤️. I listened to this lecture and took 94%and my ACLS 🙏🏾🙏🏾🙏🏾🙏🏾
@ICUAdvantage
3 жыл бұрын
This is amazing to hear!!! Way to go Agnes!
Thanks for updating dosages. I appreciate you reaching method.
Thank you for your time making this channel. you do such a great job making the difficult things easy to understand. the visual style on the screen is awesome and helps, instead of just a video of you speaking
Another great video. You are a really good teacher. I appreciate your efforts. Thanks so much.
Eddie you videos are great! They have assisted my through my ICU and cardiac ICU journeys. Now I’m using them to study for CRNA school interviews. You’re doing great work, you really deserve all the best in life!
I am INLOVE with your channel! Thank you for making this content!
@ICUAdvantage
3 жыл бұрын
Yay!!! Awesome! Glad you are liking it and truly my pleasure to do so!
Final year medic here! I wish I had known about this channel much earlier! It would have helped me massively during my surgical block! Thank you for your work!
Thanks so much Eddie. Your efforts are so appreciated and invaluable.
@ICUAdvantage
2 жыл бұрын
Truly my pleasure. Glad you appreciate the effort. 😊
Thankful that I saw the updated guidelines!!!!
You are the greatest! I am amazed on how simple but objectively you explain the subject!
@ICUAdvantage
2 жыл бұрын
Wow, thank you so much! Really glad you liked it Karem.
You are a wonderful teacher. Thank you. I made a playlist on ACLS review with your lectures. Comes handy during ACLS renewal.
Great videos. I’m studying for my CEN and starting a traveling career. Love your vids. 👍 thanks
I'm currently in paramedic school and going through ACLS and this was extremely helpful.
Eddie you are literally and metaphorically a live saver!You videos helped me to prepair for my acls course!
@ICUAdvantage
Жыл бұрын
Woohoo!! lol I'm just happy to be able to help Maria
Thank you so much for taking the time to make educational content like this! God bless you!
@ICUAdvantage
9 ай бұрын
You are very welocme Glad you enjoyed it!
Thank you so much for making these videos! I just found your channel while reviewing info for my upcoming recert in ACLS and I have to say, I'm looking forward to watching every video on your channel! You do a great job in explanation and I don't know if you're the one drawing, but you have great animations as well! On a separate note, if you don't already do a podcast, you definitely should, you've got the voice for it and I bet you have some good stories.
@ICUAdvantage
2 жыл бұрын
Truly my pleasure to help and thanks for the great comment. Yeah its a one man show here so I'm doing it all. I don't know if a podcast is up my alley or not. I certainly do have some interesting stories over the years thats for sure!
Excellent thank you so much for the review!
Hi! Thanks so much for this review. I have been in respiratory 35 years- I go through the recertification and review as usual. But today when watching your review here, I had a Lightbulb Moment!!!! When you said electrically pacing or chemically pacing, the lightbulb went on for me to remember why/when to use Dopamine or Epinephrine. I know the process on the algorithm, but just hearing the bifurcation of electrical vs chemical just clicked for me! (All these years nobody said the term “chemically pacing”, and when you did- it just clicked for me. ) Thank you !
Your amazing! The way you explain things are very easy to understand! Your videos are great for new nurses and nurses like myself who need a refresher! Thank you keep theses going please 😃
@ICUAdvantage
3 жыл бұрын
Yay! So awesome to read and hear this Anisha! Glad you liked it and thank you so much for taking the time to leave a comment.
Thank you for your video. I am about to take my ACLS and PALS in one week and this helped me tremendously.
@ICUAdvantage
3 жыл бұрын
You are very welcome Mariza! Glad they are helpful for you!
Hi Eddie, thank you for this excellent series! I’m a nursing student in CCU for my final practicum and these have been super helpful for learning and reviewing the massive amount of knowledge critical care nurses need.
@ICUAdvantage
3 жыл бұрын
So great to hear this Patrick! You are more than welcome and I'm just glad to be able to help!
I am following your lectures from Haiti. they are really helpful and I try to share them as much as possible with my friends.keep up the good work.
@ICUAdvantage
3 жыл бұрын
How cool! Hello in Haiti! I appreciate the shares and glad you like the videos. Thanks for taking the time to leave a comment!
I feel more confident and equipped in managing my patients. Thank you for all your content. Its remarkable
@ICUAdvantage
Жыл бұрын
SO great to hear this! You are very welcome and thanks for taking the time to leave a comment.
As someone who took the ACLS course online for their first time, this video has been incredibly helpful! I go for my in-person skills check-off in a few days and I am so thankful to have come across your video.
@ICUAdvantage
2 жыл бұрын
So great to hear this Paige. Best of luck on your check-off and glad the video was helpful for you!
I have my ACLS in a few days and I was freaking out but found this gem of a series. The explanation and visual representation is so clear and easy to follow through. Thank you for this series 🙏
@ICUAdvantage
2 жыл бұрын
Woohoo! Glad to hear you enjoyed the series and best of luck on your ACLS. You got this!
Very helpful and very informative. Thank you so much!
This is the 2nd one I have watched and it is excellent! I needed something like this to help me review for ACLS/PALS skills check offs next Weds. Thx!
@ICUAdvantage
2 жыл бұрын
Hope the check offs went well!
Thank you very much. It was very enriching
Listening to this channel has been better than any music that I’ve listened to. Also, a message to Eddie, keep on keeping on. Your good habits will be showcased and appreciated, stay consistent you’re doing great things.
@ICUAdvantage
3 жыл бұрын
So awesome to hear Hassan! I'm really glad to hear that you like these videos and are finding them helpful! I really appreciate the kind words and I definitely plan to keep making more videos!
This was great!! Thank you so much for taking the time to make these videos😊
@ICUAdvantage
3 жыл бұрын
So glad to hear you liked it! 😊 Happy to be able to help and let me know if I can in any way!
@jenniferroseeloff8116
3 жыл бұрын
@@ICUAdvantage Thank you 😊😊
It’s Valentine’s today. What would I do for brokencardia?
@ICUAdvantage
3 жыл бұрын
Chocolate? lol Not sure if that is AHA recommended or not!
@KyKatladi
Жыл бұрын
Alcohol 🤣
@allen480
Жыл бұрын
Visit a “professional”.
@tamiii8990
Жыл бұрын
Chocolatopine 2gr/kg/min
@allen480
9 ай бұрын
Lick some external pacemaker leads?
Thank you so much for this awesome video!!! You are a life saver!! ❤❤
Just finished the ACLS online portion. Your presentation is so much better.
@ICUAdvantage
3 жыл бұрын
Wow thank you Albert! I really appreciate the kind words!
Great video & easy to grasp! Thanks!
Great knowledge and very useful summary 👍
Nice delivery of scenario. I am doing ACLS next week and found your video.
@ICUAdvantage
Жыл бұрын
Awesome. Best of luck!
thank you so much for your lecture! it really helps me a lot while i’m studying for my first ACLS. -SN from South Korea:)
thank you so much for a great video on ACLS !!
@ICUAdvantage
3 жыл бұрын
I appreciate that! Glad you like it!
Thank you! I am a retired RN w/ Dialysis 25+ years. I love keeping current on all the critical care and EMS updates; I am CERT MedOps trained and volunteer in my community as a volunteer resource nurse.
@ICUAdvantage
2 жыл бұрын
Very cool! I'm sure I'll be the same way and still always wanting to stay current and aware of the current landscape. Glad you liked it.
Thank you. I was not updated with the new recommendation for Atropine and Dopamine. My ACLS is tomorrow!
@ICUAdvantage
3 жыл бұрын
Perfect timing! :)
Thank you so much for this algorithm. I came across with severe sinus brady - in its high 20s with no change in pressures. It lasted about 10 minutes. The patient was covid - intubated, sedated and paralysed. It is good to know about symptomatic bradycardia and its clinical symptoms so I will know next time not to panic unnecessarily. Again, thank you for sharing this video.
@ICUAdvantage
3 жыл бұрын
More than glad to help! Honestly though, if I were in your shoes, I'd probably be panicking too! Even maintaining a good blood pressure, I'd be worried they would decline further and would hope to get the rate up. At 20 there most probably were compensation mechanisms going on as I'd be real shock that such a low HR would maintain adequate perfusion. That said, I've been surprised by many things before. Were they on pressors already? What lead to the bradycardia? Hypoxia related? Curious if you ended up doing anything, or if they just resolved on their own.
@dangmateo00
3 жыл бұрын
Yes, the patient was on a small dose of Norad and was deproned 10 hrs prior to. Apparently has had episodes of bradycardia before but not as low as it did. I ended up just doing an ECG though I was not able to capture it as it resolved on its own.
I have exam after 5 days im listened to your lessons its better more than book . Thank you eddie .
@ICUAdvantage
2 жыл бұрын
Awesome! hope the exam went well!
Have to recert my medic by exam this cycle, and this has been a very helpful video series. 🤙
@ICUAdvantage
2 жыл бұрын
Awesome. Glad you enjoyed the videos!
Super helpful review! I am binge watching all your videos, I’ve been on med-surg units for a while now and I’ve been away from ICU Stepdown, I feel rusty!
@ICUAdvantage
Жыл бұрын
You've got A LOT to binge watch these days lol
Shine Bright like a diamond❤❤❤thank you
Excellent. Thank you.
This is wonderful! Thank you!
@ICUAdvantage
2 жыл бұрын
Happy to help Shellz!
Great lecture and video. Thank you:)
@ICUAdvantage
2 жыл бұрын
You're welcome. Glad you liked it! 😊
Very helpful! Thankyou
I just discover your channel. I'm a tele nurse. Very interesting and helpfull channel. I wish if we could get this information in a way to print it. Thanks a lot
Wow,explanation very nicely
may you please develop an app, your lectures are very amazing
Lovely and useful presentation 👌
@ICUAdvantage
2 жыл бұрын
Glad to hear this!
Your videos are educative
Hi thank you for your time and help very nice and helpful video
@ICUAdvantage
Жыл бұрын
Glad you liked it!
Great teaching ❤❤❤❤❤
super helpful!
Awesome explanation vro ..🎉❤
Thanks. Awesome. Great grip to me
@ICUAdvantage
3 жыл бұрын
Great to hear!
Very useful! Thank you!
@ICUAdvantage
3 жыл бұрын
Glad it was helpful!
Excellent. Q? Pls remind us how to deliver the electrical pacing like dopamine or epi. Do we infused/mixed the dopa/epi first to a saline? If yes, what proportion? If I do not have pump (not in icu setting) what is the effective way? Again, thanks very much.
Thank you so much sir for this. You're not just a life saver… your indeed a liveS saver with this content. May i also ask what software do you use for making this?
@ICUAdvantage
2 жыл бұрын
Wow, thank you so much for that! I just use Photoshop and screencast to an iPad to write with Apple Pencil.
Thank you
Thanks !
Thank you very much 🙏🏼 can you please explain VT with pulse
@ICUAdvantage
3 жыл бұрын
You are very welcome. That is actually coming next week!
Love how you teach, wondering if you can use visuals like showing the pacemakers, defibrillators, etc as you are reviewing which buttons to push? Also, always wondered why we shock pulseless Vtach, isn't it just PEA? Can you give amiodarone right after epinephrine. Since they are different classes of drugs, why do we have to wait 3-5 minutes?
@ICUAdvantage
3 жыл бұрын
Thank you! I purposely avoid device specific stuff as these videos go out all over the world and the equipment varies so much from place to place. I try to focus on foundational info that can be applied to whatever equipment you use. Also, Vtach is a disorganized rhythm that in most cases does not provide adequate perfusion. We want to stop that and allow the heart to resume a normal rhythm, hence the shock. As for the the 3-5 minutes, I don't know if I have a great answer to that. I know over the years these guidelines were developed from evidence based research by the AHA, so I'm sure there is something there. Also, we have to look at 1/2 life. 1mg of Epinephrine is quite large, especially when we compare to doses we give in Epi drips. Probably wouldn't make any difference to give it more often. And any longer and we probably don't sustain the high levels needed to provide that necessary coronary perfusion.
Thank you 😊
thank you, very useful info
@ICUAdvantage
3 жыл бұрын
Thank you so much Fe! Really happy to hear this.
So nice video big thank
Wow, what a massive amount of informations, im an SSN in general medical ward and now rotating in cardiac allocation without any mintor around for 6 months - a self learner - gained all my informations from watching your videos.. Enjoying them all, keep doing it 💫 your doing a great thing to us
You are a good teacher
@ICUAdvantage
3 жыл бұрын
Thank you so much Burton! Happy to be able to help.
Thanks, it is useful
Thank you!
@ICUAdvantage
Жыл бұрын
Youre welcome Grace!
EXCELLENT PRESENTATION
@ICUAdvantage
3 жыл бұрын
Thank you kindly!
Great lessons made so easy indeed. New subscriber here from Dubai
@ICUAdvantage
2 жыл бұрын
Very cool! Welcome aboard!
I passed my nclex a few days ago and am currently using your materials to brush up for my interview with my local ED. Thank you!!
@ICUAdvantage
2 жыл бұрын
Awesome! Hope the interview went well!
@legolasgrof
2 жыл бұрын
@@ICUAdvantage thanks! I got the job and actually started today!
@ICUAdvantage
2 жыл бұрын
@@legolasgrof Heck yeah! Congrats!
@doremifasolatido-ro7zs
2 жыл бұрын
@@legolasgrof what kind of questions they usually ask in the ED job interview?
@legolasgrof
2 жыл бұрын
@@doremifasolatido-ro7zs They asked about doses for some acls meds, important labs and initial treatment for sepsis, checking hospital protocol if you were unsure about doing something. They asked me about preping a hospital room and what the minimum necessary equiptment would be (working 02, suction etc.). They also asked about what the acls protocol for svt was. The last question was a multiple choice with three pts. One had new onset indigestion, one was a ped with a leg deformity, and the other was a copd pt with good vitals. They wanted me to identify the indigestion pt a candidate for chest pain protocol and the highest acuity pt.
Love the.presentation!!!
@ICUAdvantage
3 жыл бұрын
Glad to hear this Jane!
Thank you Icu nurse, studying
@ICUAdvantage
3 жыл бұрын
You are very welcome and best of luck on your studies!
Thanks for a great video
@ICUAdvantage
3 жыл бұрын
Glad you enjoyed it
Informative video
Awsom Thank you very much
@ICUAdvantage
3 жыл бұрын
You are very welcome!
One other point before I move on to see where the algorithm takes me next: Returning to your illustration of narrow complex 2:1 AVB, giving atropine or other agents that can increase sinus rate, but esp. atropine, to such a pt. can convert a minor or moderate problem to a severe, life-threatening crisis. The reason is that such a pt's. AV node is so dysfunctional (temporarily or permanently) that it can only conduct alternate beats. It needs that much recovery time between beats. If you accelerate the sinus rate, the AV node will have no time to recover conduction amid the frequent assaults from above. Asystole can result. Passing a temporary pacing electrode takes only a few minutes and keeps the pt. much safer.
Thank you so much
@ICUAdvantage
3 жыл бұрын
You are very welcome!
Well explain and understandble👍👍
@ICUAdvantage
2 жыл бұрын
Really happy to hear this!
All I can say is, thank you Eddie
@ICUAdvantage
2 жыл бұрын
You’re welcome! 😊
thank you
@ICUAdvantage
Жыл бұрын
YW!
Awesome, very very useful
@ICUAdvantage
2 жыл бұрын
Glad to hear it!
Very good thank you
@ICUAdvantage
3 жыл бұрын
Thank you!
Great video
@ICUAdvantage
2 жыл бұрын
Thank you!
love it
Just a quick comment - can consider dobutamine as well. one more thing stop the offending agent which is more likely cause than any other etiology in ICU. Great talk
@ICUAdvantage
3 жыл бұрын
Yes, but only in a stable Brady where we want to increase CO! Not the unstable, which is probably why that isn't mentioned in the ACLS algorithm recommendations. But yes, absolutely, treat the underlying cause. The great game of the ICU :)
Good morning Mr.Eddie regarding the atropine as you said we have to start with 1mg first not with 0.5mg But in our hospital there protocol they are started with 0.5 only then they are increasing the dosage so do you think it’s wrong or it’s ok and Also why we have to started with 1mg direct not .5 Thank you Mr.Eddie so much for you incredible work
@ICUAdvantage
3 жыл бұрын
I'm just referring to the newest guidance from the AHA. They used to recommend 0.5mg but now the latest is 1mg.
Brilliant
@ICUAdvantage
Жыл бұрын
Thank you!
Please elaborate how to increase dopamine and titrate it in full detail
@ICUAdvantage
3 жыл бұрын
kzread.info/dash/bejne/q5mZrKataZmcdLg.html Here's a good video where I give some insight on to titrating pressors which I think you might find helpful.
What is the use of isoprenaline in Bradycardia?
Your illustration of Mobitz II was just 2:1 AVB. One cannot determine with certainty that it was not Mobitz II but it's very unusual to encounter such severe conduction system disease (Mobitz II) with a narrow QRS. Urgent intervention is required for Mobitz II regardless of anything else. It can be very dangerous. If the pt. has active myocardial ischemia in the presence of a bradyarrhythmia, obviously it's much safer to give nitrates and place a temporary pacing lead than it is to give epi., etc. I would always start with 0.5 of atropine when indicated. Some pts. respond dramatically. You can always give more. Incidentally, the best effects of nitrates are rarely achieved with the pt. supine.
Insane speaking skill
@ICUAdvantage
2 жыл бұрын
Thank you!