What should be the first step in treating a pediatric patient with bradycardia whose heart rate is less than 60 bpm?

In cases of pediatric bradycardia where the heart rate drops below 60 beats per minute, it is crucial to assess the patient's condition immediately. If the child exhibits signs of poor perfusion or is unstable, the priority is to initiate effective interventions that can stabilize the patient. Cardiopulmonary resuscitation (CPR) serves as the foundational response in this scenario, especially when bradycardia is associated with cardiovascular compromise.

Starting CPR provides essential circulation to vital organs and helps maintain blood flow until more definitive treatment can be applied, such as medication administration or other interventions. This approach aligns with the resuscitation guidelines that emphasize immediate action to rectify life-threatening conditions.

Other options, such as starting IV fluids, administering epinephrine, or checking blood pressure, may be relevant later in the treatment process depending on the ongoing assessment of the patient. However, the primary focus in an acute setting with bradycardia and potential instability is to ensure the child is receiving immediate life-saving measures, which is why initiating CPR is the most appropriate first step.