pulse >60/min? YES -> reconsider diagnosis of bradycardia

unstable patient? YES -> atropine 0.5 mg IV q3-5 min up to 0.04 mg/kg (2-3 mg) or external pacing (do not wait for atropine)

continued bradycardia? YES -> dopamine 5-20 µg/kg/min or epinephrine 2-10 µg/min or isoproterenol 1mg/500ml D5W (2mic/ml) IV drip

stable patient? YES -> continue

2nd degree type II or 3rd degree heart block? YES -> external pacing as needed, prepare for transvenous pacer