Episode 1 – To Vagal or Not to Vagal: Traumatic Bradycardia

In this episode, we discuss potential bradycardia in traumatic injuries.  We touch on main differential diagnoses and their treatment options; primarily focusing on neurological injuries and how we can maximize our effectiveness.

Abraham, M., Brown, J., & Perron, A. (2016, November Vol. 17 Issue 6). Spinal Cord Injury. Trauma Reports, pp. 1-15.

Bhandarkar, P., Munivenkatappa, A., Roy, N., Kumar, V., Samudrala, V. D., Kamble, J., et al. (2017, Jan-Mar Vol.7 Issue1). On-admission blood pressure and pulse rate in trauma patients and their correlation with mortality: Cushing’s phenomenon revisited. International Journal of Critical Illness and Injury Science, pp. 14-17.

Huttemann, E., Schelenz, C., Sakka, S., & Reinhart, K. (2000, April Vol. 26 Issue 4). Atropine test and circulatory arrest in the fossa posterior assessed by transcranial doppler. Intensive Care Medicine, pp. 422-425.

Fong, E. W., MD. (2014). Case Based Pediatrics for Medical Students and Residents (2nd ed.). HI: Department of Pediatrics.

Klabunde, R. E. (2013, May 10). Regulation of Pacemaker Activity. Retrieved from http://www.cvphysiology.com/Arrhythmias/A005

Leanage, N. (2017, June 14). Teach me Anatomy. Retrieved June 23, 2017, from http://teachmeanatomy.info/head/cranial-nerves/vagus-nerve-cn-x/

Shaikh, N., Rhaman, M. A., Raza, A., Shanbana, A., Malstrom, M. F., & Al-Sulaiti, G. (2016, Oct-Dec Vol. 11 Issue 4). Prolonged bradycardia, asystole and outcome of high spinal cord injury patients: Risk factors and management. Asian Journal of Neurosurgery, pp. 427-432.

Sokhal, N., Rath, G. P., Chaturvedi, A., Singh, M., & Dash, H. H. (2017). Comparison of 20% mannitol and 3% hypertonic saline on intracranial pressure and systemic hemodynamics. Journal of Clinical Neuroscience.

2 thoughts on “Episode 1 – To Vagal or Not to Vagal: Traumatic Bradycardia

Add yours

  1. Good info. I appreciate the effort you are putting into this.

    Near the end there was a conversation about being more proactive, seeing your vitals as a whole, utilizing etCO2 (which I’ve seen demonstrated as an accurate predictor of patients imminent path ) and just skipping ahead of the PALS, or ACLS algorithm. In my years in the pediatric ICU and now in transport, I can think of only two times where I had to revert to the basic algorithms. Typically we are very cognizant of the patient and the direction they are going and “head them off at the pass” so to speak.

    It’s a scary place to be, because you think that you’re going outside of protocol or something. But in the end this kind of critical thinking, in my opinion, wins the day.

    1. Andy,

      Thank you for the feedback! You bring up a great point. A true understanding of pathophysiology is required to maximize our effectiveness with tools such as the AHA algorithms. Critical thinking is essential, especially as critical care providers!

Leave a Reply

Up ↑

%d bloggers like this: