Pulseless arrest (peds): Difference between revisions

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''See [[critical care quick reference]] for drug doses and equipment sizes by weight.''
==Asystole and PEA==
==Asystole and PEA==
*Give Epi 0.01 mg/kg (0.1 mL/kg 1:10,000) (max 1mg) q3-5min
*Give [[Epi]] 0.01mg/kg (0.1 mL/kg 1:10,000) (max 1mg) q3-5min
*Rhythm check q2min  
*Rhythm check q2min
*Prioritize adequate oxygenation and ventilation, as respiratory arrest is the most common cause of pediatric cardiac arrest
*Consider H's and T's
*Consider H's and T's
**Hypovolemia
**[[Hypoglycemia (peds)|Hypoglycemia]]
**Hypoxia
**[[Hypovolemia]]
**Hydrogen ion
**[[Hypoxia]] (most common cause of pediatric arrest)
**Hypo/hyperkalemia
**[[Acid-base disorders|Hydrogen ion]]
**Hypothermia
**[[Hypokalemia]] or [[hyperkalemia]]
**Tension pneumo
**[[Hypothermia]]
**Tamponade
**[[Tension pneumothorax]]
**Toxins
**[[Tamponade]]
**Thrombosis, pulmonary
**[[Toxins]]
**Thrombosis, coronary
**[[PE|Thrombosis, pulmonary]]
**[[ACS|Thrombosis, coronary]]


==VF/Pulseless VT==
==Ventricular fibrillation/Pulseless Ventricular Tachycardia==
*Shock as quickly as possible and resume CPR immediately
*[[Shock]] as quickly as possible and resume [[CPR]] immediately
**First shock 2 J/kg
**First shock 2 J/kg
**Second shock 4 J/kg
**Second shock 4 J/kg
**Subsequent shocks ≥ 4 J/kg (max 10 J/kg)
**Subsequent shocks ≥ 4 J/kg (max 10 J/kg)
*Give Epi if (shock + 2min CPR) fails to convert rhythm
*Give [[Epi]] if (shock + 2min [[CPR]]) fails to convert rhythm
*Perform pulse check/shock if appropriate q2min
*Perform pulse check/shock if appropriate q2min
*Give antiarrhythmic if (2nd shock +2min CPR) again fails
*Give [[antiarrhythmic]] if (2nd shock + 2min [[CPR]]) again fails
**1st line: Amiodarone
**1st line: [[Amiodarone]]
***5 mg/kg (max 300mg)
***5mg/kg (max 300mg)
***May repeat twice up to 15mg/kg
***May repeat twice up to 15mg/kg
**2nd line: Lidocaine  
**2nd line: [[Lidocaine]]
***1 mg/kg
***1mg/kg
**Magnesium
**[[Magnesium]]
***25-50mg/kg (max 2g) IV
***25-50mg/kg (max 2g) IV
***Only for polymorphic V-tach
***Only for polymorphic [[V-tach]]


==See Also==
==See Also==
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[[Category:Critical Care]]
[[Category:Critical Care]]
[[Category:Cards]]
[[Category:Cardiology]]
[[Category:Peds]]
[[Category:Pediatrics]]
[[Category:EMS]]
[[Category:EMS]]

Revision as of 03:51, 9 March 2019

See critical care quick reference for drug doses and equipment sizes by weight.

Asystole and PEA

Ventricular fibrillation/Pulseless Ventricular Tachycardia

  • Shock as quickly as possible and resume CPR immediately
    • First shock 2 J/kg
    • Second shock 4 J/kg
    • Subsequent shocks ≥ 4 J/kg (max 10 J/kg)
  • Give Epi if (shock + 2min CPR) fails to convert rhythm
  • Perform pulse check/shock if appropriate q2min
  • Give antiarrhythmic if (2nd shock + 2min CPR) again fails

See Also

References

AHA 2010 Guidelines for PALS