Know your Zoll Bradycardia

ALS Insights: Micro-Learning Education Sessions.

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Session Two:​ Know Your Zoll
By: Courtney Nowlin BSN, RN, SCRN

​Bradycardia Zoll

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Multiple Select

Knowledge Check!

Select All That Apply: What bradycardia rhythms have a higher likelihood of progressing to asystole?

• Third-degree AV Block

• Second-degree type I AV Bblock

• Second-degree type II AV block

• First-degree AV Block

Multiple Choice

To initiate pacing the nurse must switch the zoll to pacing, and turn up the output (mA) clockwise, normal range of capture is 40-80 mA. Once you have determined the patient's threshold by witnessing an extended QRS complex, what else must you do before palpating a pulse to confirm pacing.

• Turn up the mA's 20% past threshold.

• Turn up the mA's 30% past threshold.

• Turn up the mA's 10% past threshold.

• Turn up the MA's a half of turn past threshold.

Fill in the Blanks

What button on the Zoll can you push to see the underlying rhythm of the patient while pacing?

Transcutaneously Pacing

• Symptomatic Bradycardia:

  • When the heart rate is so slow that it leads to symptoms like chest pain, shortness of breath, dizziness, altered mental status, or syncope. Typically indicated when bradycardia is causing hemodynamic instability (e.g., hypotension, shock).

• Bradyarrhythmias Not Responsive to Medications:

  • When medications (e.g., atropine) are ineffective or contraindicated.

  • Conditions like sinus bradycardia, atrioventricular (AV) block (especially second-degree type II or third-degree AV block), or other significant bradyarrhythmias.

• Heart Block:

  • Especially in cases of high-degree AV block (second-degree Mobitz II and third-degree AV block) where there is a risk of progression to asystole.

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​References

​​American Heart Association (n.d.) AHA RQI program: Program overview.
https://cpr.heart.org/-/media/CPR-Files/Courses-and-Kits/RQI/RQI-Program-Overview.pdf

American Heart Association (2020). ACLS Handout.
Novant Health (2022a) NH ALS Mega Code: Unstable Bradycardia Scenario

Novant Health ( 2022b) NH ALS Mega Code: Tachy Arrhythmia Scenario

Novant Health (2022c) NH ALS Mega Code: V Fib

Novant Health ( 2022d) NH ALS Mega Code: Zoll Teaching Scenario

Novant Health (2022e) ALS Mega Code: Pre and Post Test Questions

ZOLL. (n.d.). How to use the R Series® defibrillator [Video]. ZOLL.
https://www.zoll.com/contact/elearning/videos/r-series/how-to-use