Males normally have a slower heart rate than females. Cardiovascularly
healthy people may normally have a slow (less than 60 beats per minute)
heart rate which also normally slows during sleep and rest. A slow heart rate
is significant only if it is associated with MI or cardiovascular compromise.
(a) There is no treatment if the casualty's blood pressure is normal, he
is alert, and there are no ventricular, abnormal beats.
(b) If the casualty is experiencing premature ventricular contractions
(PVCs), hypotension, or there are MI symptoms (chest pain or dyspnea), administer
atropine. The dosage for a patient NOT in cardiac arrest is 0.5 mg intravenously at 5
minute intervals until the heart rate increases to 60 beats per minute or greater and until
the signs and symptoms lessen. The dosage of atropine should not exceed 2 mg.
(c) Treat premature ventricular contractions (PVCs) with a
bradycardiac rhythm) with atropine, NOT lidocaine. The reason is that atropine may
restore the normal AV conduction system, but lidocaine may block this response.
Figure 2-13. Sinus bradycardia.