Why you should NEVER give atropine to a complete heart block!! Right?? (12)

In this episode I will talk about atropine administration and complete heart blocks. What have you always heard? "Atropine will not work in a complete heart block so don't waste your time giving it!!!" But paramedics are critical thinkers. Maybe we CAN give atropine.....when the pathophysiology makes sense!!

Have you ever heard that you cannot give atropine in a 3rd degree heart block? Let me know the situation below!

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[Ryanboy]

This is the BEST 3rd degree HB and ventricular escape presentation that I've ever heard. If I had this kind of instruction 25 years ago when I was in Paramedic school maybe I wouldn't have struggled so much with my heart block identification. You should be teaching Paramedic school!!! Great job.

[HonestJunkie]

I work EMS here in Australia …… flying the flag for you down here brother, love your channel.
Thank you

[billbombshiggy]

As a diagnosed hypochondriac, meaning I know as much as you, any nurse and many types of doctor AND in an apocalyptic situation, I would be your doctor...

I learned something.

I only panicked once when my heart fluttered from too much caffeine (big ol caffeine addict here. I over did it.) And was certain I was going into VFIB (I didn't say we were intelligent when we panicked)

[hacknr]

Awesome vid! Learned something new, thank you!!

[jeppefrahm]

Thanks you for a great visual review.

I'm struggling a bit to find publications or studies that refer to atropine's effect on narrow 3rd degree av block, and lack of effect on wide qrs.
can you guide me in the direction of some published journals, studies or publications.

Best regards, Jeppe

[briandunnigan]

We don’t have to empirically push meds because the cookbook says to.
Think, stable patient don’t break what’s not broken….
Understanding your physiology helps make better patient decisions.

[belgianmalinoit]

For decades atropine was gospel for bradycardia, then it went into chicken soup mode “Meh, can’t hoit.” This is the most cogent explanation of the why part. Bradycardia is tricky; pacing is a maybe at best and any direct beta stimulation will drive MvO2 through the roof. Things get so much harder when you actually apply science…

[BayTour]

Why has AHA ACLS recommended administering 1mg Atropine to any heart block prior to pacing on a stable patient? I believe it has been in the guidelines since the 2015 revision. As an ACLS instructor I have to explain to my class that even though the AHA has it in their algorithm, it’s not going to work in 3rd degree block, so ignore it and consider pacing immediately. I teach there are absolutely times to punt the football in the field with a stable patient. In general, stable gets medicine and unstable gets Edison medicine. Are you able to help clarify this recommendation for me? I am there for my students and not my ego. I would like to have an explanation rather than “forget it because it doesn’t work.” I appreciate your time.

[davidbaldwin]

I was fascinated to see a group of animal vets convene with physicians. Vets get to try things on animals that are a no-go for people. Seems funny at first, but ppl spend mad money to save pets, sending vets to some distant corners of treatment.