6. Junctional beat without retrograde conduction Junctional beat with retrograde conduction ( p wave superimposed on QRS complex) Prolonged return cycle following retrogradely conducted junctional beat
7. DIAGNOSIS Junctional escape rhythm possible sinus node dysfunction DIFFERENTIAL DIAGNOSIS A) SICK SINUS SYNDROME B) CAD (ACUTE OR CHRONIC) C) CARDIOMYOPATHY D) INFLAMMATORY E) IATROGENIC
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11. APPROACH TO BRADYARRYTHMIAS BRADYCARDIA HR<60 MAINTAIN PATENT AIRWAY ASSIST BREATHING GIVE O2 MONITOR ECG,BP,OXIMETRY ESTABLISH IV ACCESS SIGNS & SYMPTOMS OF POOR PERFUSION NO YES OBSERVATION *PREPARE FOF TRANSCUTANEOUS PACING ,USE WITHOUT DELAY FOR HIGH DEGREE BLOCK(TYPE 2nd&3 rd DEGREE AV BLOCK) *CONSIDER ATROPINE 0.5 mg WHILE AWAITING PACING MAY REPEAT TO A TOTAL DOSE OF 3 mg, IF INEFFECTIVE TRY PACING *CONSIDER EPINEPHRINE 2-10 mcg/min OR DOPAMINE 2-10mcg/kg/min INFUSION WHILE AWAITING PACER OR IF PACING IS INEFFECTIVE
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