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. | *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) | ||
** | **[[Acid-base disorders|Hydrogen ion]] | ||
**Hypothermia | **[[Hypokalemia]] or [[hyperkalemia]] | ||
**Tension | **[[Hypothermia]] | ||
**Tamponade | **[[Tension pneumothorax]] | ||
**Toxins | **[[Tamponade]] | ||
**Thrombosis, pulmonary | **[[Toxins]] | ||
**Thrombosis, coronary | **[[PE|Thrombosis, pulmonary]] | ||
**[[ACS|Thrombosis, coronary]] | |||
== | ==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]] | ||
*** | ***5mg/kg (max 300mg) | ||
***May repeat twice up to 15mg/kg | ***May repeat twice up to 15mg/kg | ||
**2nd line: Lidocaine | **2nd line: [[Lidocaine]] | ||
*** | ***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: | [[Category:Cardiology]] | ||
[[Category: | [[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
- Give Epi 0.01mg/kg (0.1 mL/kg 1:10,000) (max 1mg) q3-5min
- 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
- Hypoglycemia
- Hypovolemia
- Hypoxia (most common cause of pediatric arrest)
- Hydrogen ion
- Hypokalemia or hyperkalemia
- Hypothermia
- Tension pneumothorax
- Tamponade
- Toxins
- Thrombosis, pulmonary
- Thrombosis, coronary
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
- 1st line: Amiodarone
- 5mg/kg (max 300mg)
- May repeat twice up to 15mg/kg
- 2nd line: Lidocaine
- 1mg/kg
- Magnesium
- 25-50mg/kg (max 2g) IV
- Only for polymorphic V-tach
- 1st line: Amiodarone
See Also
References
AHA 2010 Guidelines for PALS