Case No. 99

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Case No. 99

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Chief Complaint:

Bradycardia and Syncope

Published: Aug. 31, 2017
Case No. 99
Author: Jason2475
CASE SCENARIO

A 68year old male presents to the Emergency Department after syncope in a restaurant. The patient was waiting for his meal when he complained of nausea, became pale, and fainted onto the floor. He had a minor head strike during the fall. When EMS arrived they noted that the patient was bradycardic to the 30s, somnolent, and pale appearing. In the Emergency Department he is found to have a HR of 32, BP 77/43, RR 18, O2Sat 97% on 2L NC. He is afebrile. You obtain IV access and place the patient on the cardiac monitor. EKG shows a sinus bradycardia. IV access is obtained.

QUESTION

What action should be performed next?

cardiology consultation
administration of atropine
perform transcutaneous pacing
perform intravenous pacing
transfer the patient to the CCU