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Pediatric: Cardiac Arrest Asystole /Pulseless Electrical Activity

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Pediatric: Cardiac Arrest Asystole /Pulseless Electrical Activity Pediatric: Cardiac Arrest Asystole /Pulseless Electrical Activity Guideline Reviewed: 2017 Updated: 2017 PEARL/S: • If pediatric pads are not available, use of adult pads is acceptable. Ensure they do not touch. • IV medications should be followed by a 2-3 mL flush of NS in most proximal port. • ETT placement should be confirmed every time the patient is moved or for change of status. • Continuous ETCO2 is mandatory in intubated patient. • Consider orogastric tube for abdominal distention. • Use length-based resuscitation tape. Medication Medication Newborn 10 kg 12 kg 15 kg 20 kg 22 kg 25 kg 30 kg Name Dose Epi 1:10,000 0.01 mg/kg 0.5 mL 1 mL 1.2 mL 1.5 mL 2 mL 2.2 mL 2.5 mL 3 mL (Adrenalin) Universal Care Guidelines with an emphasis on adequate oxygenation EMT Pediatric: Cardiac Arrest – Basic Life Support Guideline Epinephrine 1:10,000: 0.01 mg/kg, IV/IO, maximum 1 mg, repeat every 3 – 5 minutes I/P Identify and treat reversible causes (see above) Pediatric: Cardiac Arrest Basic Life Support Guideline Reviewed: 2017 Updated: 2017 PEARL/S: • If pediatric pads are not available, use of adult pads is acceptable. Ensure they do not touch. • IV medications should be followed by a 2-3 mL flush of NS in the most proximal port. • ETT placement should be confirmed every time the patient is moved or for change of status. • Continuous ETCO2 is mandatory in intubated patient. • Consider orogastric tube for abdominal distention. • Use length-based resuscitation tape. Universal Care Guidelines, with emphasis on adequate oxygenation Check adequacy of CPR. Perform chest compression if HR persistently < 60 in child/infant or neonates AED Guideline using pediatric pads. Use adult pads when using EMT multifunction device in AED mode, if no pediatric pads available. Ensure pads do not touch place anterior and posterior Ensure patient warmth Transport immediately with BLS measures while requesting ALS A IV/IO/Vascular Access Consider supraglottic airway Consider ET – Paramedic only I/P Evaluate cardiac rhythm. Go to appropriate guidelines for further management Pediatric: Cardiac Arrest Ventricular Fibrillation/Pulseless Ventricular Tachycardia Guideline Reviewed: 2017 Updated: 2017 PEARL/S: • Sodium bicarbonate should not be used during brief resuscitation attempts. • If pediatric pads are not available, use of adult pads is acceptable. Ensure they do not touch. • IV medications should be followed by a 2-3 mL flush of NS in the most proximal port. • ETT placement should be confirmed every time the patient is moved or for change of status. • Continuous ETCO2 is mandatory in intubated patient. • Consider orogastric tube for abdominal distention. • Use length-based resuscitation tape. Universal Care Guidelines with an emphasis on adequate oxygenation Pediatric: Cardiac Arrest - Basic Life Support Guideline EMT AED Guideline using pediatric pads if stand-alone defibrillator. Use adult pads when using multifunction device in AED mode, if no pediatric pads available Ensure pads do not touch Attempt defibrillation at 2 j/kg Epinephrine 1:10,000; 0.01 mg/kg, IV/IO, maximum 1 mg, repeat every 3 – 5 I/P minutes Attempt defibrillation at 4 j/kg after two (2) minutes of CPR. Continue every two (2) minutes Med Consider amiodarone (Cordarone®) 5 mg/kg IV or IO Control .
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