Severe bradycardia drug — DipIMC MCQ

Correct answer: B — Atropine 500 micrograms intravenously

Explanation lettering: C = shown as A · A = shown as B · D = shown as C · B = shown as D

A is correct: Unstable adult bradycardia is initially treated with intravenous atropine 500 micrograms while preparing escalation. B is less suitable because cardiac-arrest adrenaline dosing is inappropriate in a perfusing patient; C is less suitable because a large initial opioid bolus risks hypotension and respiratory depression; D is less suitable because the dose is below standard severe adult asthma nebuliser dosing; E is less suitable because it is a common auto-injector dose rather than the adult healthcare dose. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.

Reference: Resuscitation Council UK Guidelines 2025; JRCALC Guidelines