Recently at my new job, I've seen a couple peri-code practices that I thought were quite strange, and I'm wondering what you guys think.

1.) A patient brady'd down to ~30's as two nurses were turning her. I ran in the room and immediately got a strong femoral pulse. BP ~50's/30's via art line. Primary nurse calls out for the tech to start compressions. I'm like, "I have a pulse!" and she's like, "start compressions anyways!" After the first round of compressions, I had lost the pulse. After the second round, ROSC. In hindsight, I though I would have much rather just given atropine. The patient was obviously on the doorstep of coding, but why start compressions while I have a pulse? This was probably vasovagal which atropine would have immediately fixed. Thoughts?

2.) Get ROSC on a different patient, strong pulse ~70s. Doctor calls out for a 1 minute round of chest compressions AFTER ROSC! This doc was a pulmonologist and one of the smoothest code runners I've ever worked with, so I'm like, "Does he know something I don't know?" Clearly he knows a lot of things I don't know, but CPR after ROSC? I prefer to stay off the chest whenever possible lol.


I'm currently studying for PALS initial cert, and I see that in symptomatic bradycardia in peds, you DO start compressions. This makes me think the first nurse may not have been that far off.