What is the appropriate action to take after administering atropine if there is no significant change in the patient's condition?

The appropriate action after administering atropine and observing no significant change in the patient's condition is to prepare the patient for transcutaneous pacing. Atropine is a medication often used in the management of bradycardia, but if the patient's heart rate does not improve or if the patient remains symptomatic, further intervention is required.

In this situation, while administration of more atropine may seem logical, it is important to note that the effectiveness of atropine diminishes with repeated doses in some cases, particularly in high-degree heart block scenarios. Therefore, simply increasing the dose does not guarantee a better outcome.

Transcutaneous pacing is indicated when there is persistent bradycardia that leads to hemodynamic instability. By utilizing pacing, one can provide immediate and effective support to the patient's heart rhythm, ensuring better circulation and oxygen delivery to vital organs.

Starting CPR, while critical in certain scenarios, is not the first line here unless the patient becomes unresponsive or goes into cardiac arrest. The goal is to stabilize the patient through pacing before considering CPR, which is a more aggressive intervention.

Thus, preparing the patient for transcutaneous pacing is the appropriate and most effective next step in managing continued bradycardia after atropine has been administered without significant improvement.