PALS Bradycardia Algorithm

Key components of the PALS cardiac arrest algorithm include

1. Assessment and Initial Interventions (1)
   The algorithm begins with an assessment of the patient’s condition and the implementation of initial interventions. This involves identifying and treating the underlying cause, maintaining airway patency, assisting breathing, providing oxygen, and establishing IV/IO access.

2. Evaluation for Cardiopulmonary Compromise (2)
   This involves thoroughly evaluating the patient for signs of cardiopulmonary compromises, such as hypotension, changes in the level of the patient’s consciousness, or other signs of shock.

3. CPR and Perfusion Assessment (3)
   In cases of inadequate perfusion or a heart rate less than 60/min, CPR should be initiated, and healthcare providers should continuously monitor for signs of inadequate perfusion while providing CPR.

4. Persistent Bradycardia Management (4)
   If bradycardia persists despite initial interventions, the algorithm recommends supporting the patient and seeking expert consultation.

5. Medication Administration and Advanced Interventions (5)
   Medications should be administered, such as epinephrine IV/IO or atropine if the issue is related to increasing vagal tone or primary AV block. Advanced interventions like transcutaneous pacing (TCP) or transvenous pacing (TVP) should also be considered while continuing to identify and treat the underlying cause.

6. Transition to Cardiac Arrest Algorithm (6)
   In the event that the patient develops pulseless arrest, healthcare providers should promptly transition to the Cardiac Arrest Algorithm to initiate appropriate interventions for managing cardiac arrest.