An 80-year-old male has collapsed with BP 90/40; pulse rhythm is shown on ECG and respiratory rate is 20. What should you do?

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Multiple Choice

An 80-year-old male has collapsed with BP 90/40; pulse rhythm is shown on ECG and respiratory rate is 20. What should you do?

When a patient collapses with low blood pressure and a slow, bradycardic rhythm on ECG, the heart isn’t delivering enough output to maintain perfusion. The immediate goal is to quickly improve heart rate and blood flow. Transcutaneous pacing provides rapid, noninvasive electrical stimulation to the heart, forcing it to beat faster and restoring forward flow. This is especially important if the rhythm is a high‑degree AV block or other bradyarrhythmia where atropine is unlikely to work. Defibrillation isn’t appropriate because there’s a nonshockable or nonarrest rhythm, and CPR isn’t needed since there’s still a pulse and some perfusion. Pacing acts as a bridge to stabilize the patient while you address underlying causes or arrange definitive pacing.

When a patient collapses with low blood pressure and a slow, bradycardic rhythm on ECG, the heart isn’t delivering enough output to maintain perfusion. The immediate goal is to quickly improve heart rate and blood flow. Transcutaneous pacing provides rapid, noninvasive electrical stimulation to the heart, forcing it to beat faster and restoring forward flow. This is especially important if the rhythm is a high‑degree AV block or other bradyarrhythmia where atropine is unlikely to work. Defibrillation isn’t appropriate because there’s a nonshockable or nonarrest rhythm, and CPR isn’t needed since there’s still a pulse and some perfusion. Pacing acts as a bridge to stabilize the patient while you address underlying causes or arrange definitive pacing.

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