Hello, med students. My name is Zach Olson, and thank you for downloading this week's

episode of the EM Clerkship Podcast. A few weeks ago, we talked about dysrhythmias, specifically

tachycardia, and we covered the five categories of tachycardias that you needed to know for your clerkship.

And they were sinus tachycardia, narrow and regular tachycardia, narrow and irregular, wide and regular, wide and irregular, with a basic approach to each one of those.

This week is the exact opposite episode. This week we're

talking about bradycardia. Here's your case. University Hospital, Medicaid,

in Route U.S., approximately five minutes with a 64-year-old female complaint of the slow heartbeat.

On arrival showed Bratacartic on the monitor at 35.

We are pacing her currently at 72.

She was 80 over 50 on the blood pressure.

Respirationers are at 18.

She is cool and slightly diaphoretic. She's also lethargic, but still talking to us. No prior medical history, no medications and no allergies,

and we'll be arriving to you in about five minutes.

All right. So a lot going on here, right, but this is a patient who is bradycardic.

By far, the most important thing that you need to remember about bradycardia is your core differential. Lots of things, I suppose, can technically cause bradycardia, but drugs, ischemia,

electrolytes are your biggest players here.

Someday we'll cover each of those in their own episode, but there is a group of drugs

called the Brady Bunch, and they include calcium channel blockers,

beta blockers, dejoxin, and clonidine, and they are all notorious for causing hypotensive

bradicardia, or low and slow, as some people call it.

Eschemia, and this makes sense.

A lot of these bradacardias aren't sinus bradycardia,

...