treatment for atrial flutter with advanced block

[Painter1]

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in atrial flutter if you have for example 4:1 conduction and the patient is bradycardiac but stable how do you treat it? if you give atropine i imagine you can convert it to a 1:2 or even a 1:1 making matters worse.

 

[bluejay68]

So if the patient is not symptomatic with a good BP, I wouldn't do anything. I would have them on a monitor with pacing pads on their chest, perhaps atropine at the bedside. If very brady (<40), and heart rate is not due to meds, I would call Cards for question of temp wire/pacer placement and admit.

If bradycardia was due to BB (may be case for aflutter patient), and they dropped their BP or had symptoms I'd also give Glucagon.