Ep 154: 4-Step Approach to Bradycardia and Bradydysrhythmias

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 6 April 2021

⏱️ 66 minutes

🔗️ Recording | iTunes | RSS

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Summary

How do we figure out when bradycardia is due to a medical illness and when it is a primary cardiac problem? What are the 4 immediate life threatening diagnosis that we have to entertain and address in the first few minutes of the sick bradycardic patients? What are some key ECG patterns that are sometimes missed by ED docs that can have devastating consequences? How can we better understand Torsades de Pointes by understanding AV blocks? How can we better understand Mobitz l and ll using 'The Dorian' approach? What is BRASH syndrome and how can we recognize it? In this main episode podcast 4-step Approach to Bradycardia and Bradydysrhythmias with electrophysiologist, educator and researcher Dr. Paul Dorian and Chair of Education for the ED at Cook County Hospital Dr. Tarlan Hedayati, we dig deep into bradycardia...

Transcript

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0:00.0	Welcome to the Emergency Medicine Cases podcast. I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine from EMC studios in Toronto.
0:13.8	EM cases is part of Shremi, the Schwartz-Riseman Emergency Medicine Institute. That's the nonprofit organization dedicated to improving EM care through high
0:21.4	quality research and education. The opinions expressed on this podcast are intended for general
0:24.8	information and educational purposes only and should not be used to diagnose treat or prevent any
0:27.3	medical condition, nor should they be used as a substitute for medical advice from a qualified
0:29.5	practicing physician. Unless stated otherwise, the opinions expressed by the hosts or guests are made in
0:32.0	their individual capacity, not on behalf of the Institute nor medicine cases.
0:50.7	Did you feel that? There are few sounds that can make an emergency doctor's heart rate go as fast as their
0:55.8	patients is going slowly.
0:58.4	Really, really slowly.
1:01.6	But not all bradicardias are created equal.
1:04.7	Just as Martin Brady, the UK resident, who set the record for the lowest resting heart rate
1:10.5	in a healthy individual
1:11.5	at 27 beats per minute. And I'm going to say that name one more time so the delicious
1:16.4	irony isn't missed. Martin Brady. You just can't make this stuff up. So what's the deal?
1:24.3	When should we care about bradicardia? Clearly not all braddies are created equal. How do we
1:30.9	figure out when it's due to a medical illness and when it's due to a primary problem? When does
1:35.7	atropine work? And when is it just as well to squirt it on the floor? Should transvenous pacing
1:41.4	be in our toolbox? Or is this beyond the ED's docks scope?
1:45.9	In this podcast, we'll outline a four-step approach to bradicardia and tell you about some exceptions and tricky situations to be aware of.
1:55.4	We'll move on to drug and electrical treatment options, diving deep into the literature or lack thereof, and offer you
2:02.4	some procedural tips and tricks to boot. And to help us through this, I'd like to welcome back
	...

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