CardiologyEmergency Medicine
Bradycardia Management
Assessment and treatment of symptomatic bradycardia including AV blocks, sick sinus syndrome, and pacing indications.
Source: Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
Step 1 of ~8
question
Is the Patient Haemodynamically Compromised?
Adverse features indicating haemodynamic compromise:
• Syncope or pre-syncope
• Chest pain (cardiac ischaemia from low output)
• Heart failure signs
• Shock (SBP <90 mmHg, pale, sweating)
HR <40 bpm or pauses >3 seconds = high risk regardless of symptoms.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Aciclovir 800mg Tablets (Ramsay Hunt Syndrome / Herpes Zoster Oticus) · Antiviral — nucleoside analogue (herpes zoster treatment)
- Silicone Gel / Sheeting (Scar Management) · Medical Device / Topical Scar Treatment
- Atropine (Anaesthesia/Bradycardia) · Anticholinergic / Parasympatholytic
- Insulin (IV Infusion — ICU Glucose Control) · Insulin — ICU Glucose Management
- Sodium Chloride 3% (Hypertonic Saline) · Hypertonic Electrolyte Solution — ICP/Hyponatraemia Management
- Dapsone · Anti-inflammatory / Antimicrobial
Pathways
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
- Syncope Assessment · ESC 2018 Syncope Guidelines; NICE NG109
Featured in these MRCEM clinical pathways
A deeper exam-focused version of this pathway is available on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only. Always apply local guidelines and clinical judgement.