Adult Bradycardia Management (ACLS) — free guideline decision tool
This tool summarizes ACLS management of adult symptomatic bradycardia: atropine first-line, then transcutaneous pacing or dopamine/epinephrine infusion.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
Runs in your browser
No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Situation | Symptomatic (hypotension/acute altered mental status/shock/ischemic chest pain/decompensated heart failure) |
|---|
→ACLS bradycardiaAtropine → pacing/infusion
- Atropine (first-line)：1 mg IV/IO, repeat every 3–5 minutes, maximum cumulative 3 mg
- If ineffective (second-line, equivalent)：Transcutaneous pacing (TCP, immediately available); or dopamine infusion 5–20 μg/kg/min (taper slowly); or epinephrine infusion 2–10 μg/min. Titrate all to clinical improvement
- Further：Consider transvenous pacing, expert (cardiology/EP) consult; correct reversible causes (ischemia, hyperkalemia, drug toxicity — e.g. glucagon for β-blocker, antibody for digoxin)
| Situation | Well-perfused / no serious symptoms |
|---|
→ACLS bradycardiaObserve and monitor
- Management：Maintain airway/oxygen (if needed), monitor, establish IV access, 12-lead ECG; identify and treat reversible causes (H's & T's, drugs, electrolytes, ischemia)
- Follow-up：No immediate medication needed if no serious symptoms; continue observation, specialist consult if needed
- Basis：AHA 2025 Adult Bradycardia Algorithm
Common questions
What is Adult Bradycardia Management (ACLS)?
This tool summarizes ACLS management of adult symptomatic bradycardia: atropine first-line, then transcutaneous pacing or dopamine/epinephrine infusion.
How is Adult Bradycardia Management (ACLS) calculated? What is the core formula?
Branches: stable (observe, treat reversible causes) → symptomatic (atropine 1 mg q3–5min, max 3 mg → TCP or dopamine 5–20 μg/kg/min (taper slowly) or epinephrine 2–10 μg/min) → high-grade block (pacing first, bridging infusions).
When is Adult Bradycardia Management (ACLS) used?
Use to triage bradycardia by severity — observe if well-perfused, escalate to atropine and pacing if symptomatic, and pace first for high-grade (infranodal) block — while always seeking reversible causes.
What are the key clinical points for Adult Bradycardia Management (ACLS)?
Atropine is usually ineffective in Mobitz II, third-degree block, or new wide-QRS escape — pace early rather than delaying with repeated atropine. (original synthesis · not guideline verbatim) Atropine dose is 1 mg every 3–5 minutes to a maximum of 3 mg Transcutaneous pacing, dopamine infusion, and epinephrine infusion are equivalent second-line options titrated to clinical improvement.
What are the limits and cautions when using Adult Bradycardia Management (ACLS)?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
Does Adult Bradycardia Management (ACLS) upload patient data? Where is it calculated?
Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
How is Adult Bradycardia Management (ACLS) calculated in practice? Can you show a worked example?
Inputs: Situation Symptomatic (hypotension/acute altered mental status/shock/ischemic chest pain/decompensated heart failure) → Result: ACLS bradycardia Atropine → pacing/infusion（Atropine (first-line): 1 mg IV/IO, repeat every 3–5 minutes, maximum cumulative 3 mg, If ineffective (second-line, equivalent): Transcutaneous pacing (TCP, immediately available); or dopamine infusion 5–20 μg/kg/min (taper slowly); or epinephrine infusion 2–10 μg/min. Titrate all to clinical improvement, Further: Consider transvenous pacing, expert (cardiology/EP) consult; correct reversible causes (ischemia, hyperkalemia, drug toxicity — e.g. glucagon for β-blocker, antibody for digoxin)） Inputs: Situation Well-perfused / no serious symptoms → Result: ACLS bradycardia Observe and monitor（Management: Maintain airway/oxygen (if needed), monitor, establish IV access, 12-lead ECG; identify and treat reversible causes (H's & T's, drugs, electrolytes, ischemia), Follow-up: No immediate medication needed if no serious symptoms; continue observation, specialist consult if needed, Basis: AHA 2025 Adult Bradycardia Algorithm）
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This tool summarizes ACLS management of adult symptomatic bradycardia: atropine first-line, then transcutaneous pacing or dopamine/epinephrine infusion.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
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