EMFANA

Emergency Medications for Anaesthesic Nurses Australia

** Bradycardia

What is Atropine?

Atropine is a drug used to increase heart rate and dry up secretions. In anaesthesia, it is mainly used when a patient has a low heart rate called bradycardia (common medication used during cardiac arrest).

Common Adult Dose

A common adult dose is 0.5–1 mg IV for antivagal effect or to reduce secretions.
In cardiac arrest with bradyasystole, if label lists 1 mg IV, repeated every 3–5 minutes up to 3 mg total.
Always follow your local protocol, anaesthetist’s order, and check dosing.

When is it often used?

slow heart rate (bradycardia)
vagal bradycardia
during cardiac arrest to increase heart rate
a need to reduce saliva or airway secretions
a need to reduce muscarinic side effects from drugs such as reversal agents

TYPICAL VIALS AVAILABLE

If the atropine ampoule says 600 micrograms in 1 mL, then 1 mL will give 0.6 mg dose
If the atropine ampoule says 1.2 mg in 1 mL, then 0.5 mL will give 0.6 mg dose
If the atropine ampoule says 1.2 mg in 1 mL, then 1 mL will give 1.2 mg

EXAMPLES OF PREPARE ATROPINE

Usually atropine is given as direct IV injection during an emergency
If smaller doses required, dilute 600mcg of atropine with 5ml of 0.9% sodium chloride (giving 100micrograms/ml and a total of 6ml of fluid - you will need a 10ml syringe for this)

What usually happens after atropine administration?

The patient’s heart rate should rise. Secretions may reduce. It is not mainly used to raise blood pressure.

Common side effects

tachycardia
dry mouth
blurred vision
urinary retention
less sweating