Epinephrine vs. atropine for bradycardic periarrest

PulmCrit

Epinephrine vs. atropine for bradycardic periarrest

PulmCrit - February 13, 2017 - By Josh Farkas

• "It may be useful to make a distinction between patients with stable, symptomatic bradycardia versus patients who are actively dying from bradycardia (bradycardic periarrest). The best approach to these situations is different.
• Epinephrine may be superior for patients with bradycardic periarrest for three reasons:
• (1) It works in a broader range of bradycardias.
• (2) It provides more powerful hemodynamic support (chronotropy, inotropy, and vasoconstriction).
• (3) It doesn't cause paradoxical bradycardia.
• The best initial medical therapy for bradycardic periarrest may be push-dose epinephrine, followed by an epinephrine infusion. However, this shouldn't delay efforts to perform electrical pacing as well."