The 12 Rhythms of Christmas: Sinus Bradycardia

This article is the second in our latest series, The 12 Rhythms of Christmas, where each day we examine a new rhythm disorder. It is a continuation of the theme behind of last year’s 12 Leads of Christmas. We were almost day behind kicking off the series (a peril of posting around the holidays), so I’m going to interrupt my planned order with an easy post to get things back on schedule. The arrhythmia hinted at near the end of the first post will instead be revealed tomorrow. Last year I posted a nearly identical article titled Don’t let your bradycardic patient D.I.E., but this is an update focused on sinus bradycardia and with a slightly new mnemonic. Our new post should be called, Don’t let the cause of bradycardia H.I.D.E.. Sinus Bradycardia I’ve told you before that I’m terrible with mnemonics, but there is one I used to find both memorable and useful: the DIE mnemonic for insidious but reversible causes of bradycardia in the emergency medicine and acute care setting. DIE stands for drugs, ischemia, electrolytes. While I love its simplicity, I no longer rely on that exact mnemonic because it leaves out an important cause of bradycardia you do not want to miss—hypothyroidism. Unlike ischemia, hypothyroidism is not a major concern from a prehospital perspective, and unlike hyperkalemia, it’s not quickly reversible, but given its importance in the trajectory of a patient’s care and how easily it can be overlooked, I think it sti...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: 12 Rhythms of Christmas Vince DiGiulio Source Type: research