A 82-year-old man arrives with weakness and repeated syncope. Triage acuity is ESI 2; BP 84/48 mm Hg, HR 32/min, SpO2 95%. ECG shows complete AV

Question

A 82-year-old man arrives with weakness and repeated syncope. Triage acuity is ESI 2; BP 84/48 mm Hg, HR 32/min, SpO2 95%. ECG shows complete AV dissociation with a wide escape rhythm. Atropine has not improved the rate. Which of the following is the most appropriate initial action?

Accepted Answer

Begin transcutaneous pacing

Answer

Administer adenosine rapid IV push

Answer

Observe while arranging outpatient Holter monitoring

Answer

Give IV diltiazem

Answer

Give oral beta-blocker therapy

Complete heart block — ABEM Board MCQ

A 82-year-old man arrives with weakness and repeated syncope. Triage acuity is ESI 2; BP 84/48 mm Hg, HR 32/min, SpO2 95%. ECG shows complete AV dissociation with a wide escape rhythm. Atropine has not improved the rate. Which of the following is the most appropriate initial action?