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For bradycardia, consider etiology: electrolytes (hyperkalemia?), drugs (beta blockers?), ischemia. Narrow complex bradycardia => atropine (wide complex bradycardia not atropine sensitive); atropine - go slowly and start low (0.25) especially in face of ischemia. All bradyarrhythmias: Dopamine drip. Epi drip. Pacemaker. Comment: Key steps are to determine unstable vs stable, wide or narrow, then slow or really slow. Electrolytes, drugs (beta blockers, calcium channel blockers), ischemia? Wide complex bradycardias are more serious; not atropine sensitive. Dopamine drips helpful. If all else fails: pacemaker. Transcutaneous pacemaker frequently fails; will need transvenous pacemaker. HippoEM 2014 b    (retrieved Feb, 2014). There are currently 1090 pearls in the database. While every attempt has been made to ensure accuracy, mistakes can and do occur. Use databank at your own risk. All pearls © 2024 by the Internet Medical Association. Click Here to view more medical pearls.