Question

For second degree type 2 or third degree blocks, avoid relying on atropine and instead prioritize what two interventions?

Answer 1

In cases of second degree type 2 or third degree AV blocks, prioritize transcutaneous pacing and the administration of dopamine or epinephrine, as atropine is ineffective. A permanent pacemaker may be required for stable patients at risk.

Step-by-step explanation:

For second degree type 2 or third degree AV blocks, it is recommended to avoid relying on atropine due to its limited efficacy in these cases. Instead, the two key interventions to prioritize are transcutaneous pacing or the administration of dopamine or epinephrine as temporizing measures until a more permanent treatment, like transvenous pacing, can be established. Immediate treatment with these interventions is crucial as these types of blocks can signify more serious underlying problems with the cardiac conduction system, and they carry a significant risk of progression to complete heart block or asystole. For patients who are stable but at risk for progression to more serious blocks, implantation of a permanent pacemaker might be necessary.