Approach to bradycardia Quiz: Ace Your Exams
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A 72-year-old man is brought to the emergency department for evaluation of altered mental status, and chest discomfort. The patient has not had fever, cough, diarrhea, nausea, or vomiting. Past medical history is significant for hypertension and diabetes mellitus type 2. Temperature is 36.2°C (97.2°F), blood pressure 100/60 mmHg, pulse is palpable at 42/min, respiratory rate 22 breaths/min, and oxygen saturation 94% on 4L nasal cannula. The patient is awake but disoriented to place, time, and person and appears pale and diaphoretic. IV access is obtained, and IV fluids are initiated. An ECG is performed and is shown below. Which of the following is the best initial step in management?

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