Should pacing be delayed while waiting for IV access in bradycardia management?

• A. Yes
• B. No
• C. Only if BP is normal
• D. Only if HR > 60

Answer: (B)

In symptomatic bradycardia with signs of poor perfusion, the priority is to restore heart rate and perfusion quickly. Start transcutaneous pacing immediately if available, and pursue IV or IO access in parallel. Do not delay pacing while waiting for IV access, because delaying can worsen hypoperfusion. Once pacing is underway, you can obtain IV/IO access and administer medications or fluids as indicated. If access is difficult, IO is a rapid alternative, and continue pacing as needed.