Recommendations	Class	Level
In a patient who arrests with asystole or extreme bradycardia with a rate of less than 30 bpm, external pacing or percussion pacing should be attempted prior to chest compressions.	IIa	C
If either external or percussion pacing is ineffective and the cardiologist feels that there is a persisting bradycardia as the cause of the arrest a temporary pacing wire should be inserted while chest compressions are performed.	IIa	C