What is the recommended first dose of IV atropine for managing bradycardia?

The recommended first dose of IV atropine for managing bradycardia is 1 mg IV. Atropine works by blocking the effects of the vagus nerve on the heart, which increases heart rate by inhibiting parasympathetic activity. In cases of symptomatic bradycardia, the standard practice is to start with 1 mg because this dosage is effective in reversing bradycardic conditions in many patients.

In clinical protocols, 1 mg is considered a safe and appropriate initial amount to ensure a sufficient physiological response while allowing for follow-up doses if necessary. If bradycardia persists, additional doses can be given at intervals of 3-5 minutes, up to a total of 3 mg. This stepwise administration helps to provide an effective management strategy for bradycardia.

In contrast, lower doses, such as 0.5 mg or 0.25 mg, do not align with evidence-based practices in emergency care guidelines for rapid response to symptomatic bradycardia. A higher dose, like 2 mg, may be more than what is recommended for initial treatment, increasing the risk of side effects without providing additional benefit. Thus, the guidance emphasizes 1 mg IV as the standard starting dose for