PEDS

Asystole or PEA

Algorithm

 

Initiate or maintain CPR
► High-flow oxygen by BVM

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►IV / IO vascular access without interruption of CPR

For PEA administer Fluid Bolus before other treatments
►20 mL/kg NS bolus, may repeat twice to attain and maintain perfusion

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If no immediate response to initial 250 mL Normal Saline bolus:

►Epinephrine 0.01 mg/kg IV / IO (0.1 mg/mL) approximately every 3 minutes

 

→ Correct possible reversible causes:

hypovolemia, acidosis hypoxia, tension pneumothorax, hypothermia, toxins

 

→ If known diabetic and hypoglycemia suspected administer:
►D10 25 gm/250 mL (50% solution) IVPB / IO (See Dosing / Age Chart Below)

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If at any time develops rhythm with pulse:

Make BHC for transport destination
For continued PEA or asystole:
▼
→Maintain CPR and transport to nearest PRC or make Base Contact to: - Provide further resuscitation orders
- Request pronouncement of patient in the field

 

→Interruption of chest compressions should always be held to a minimum

 

→Agonal gasps are not adequate breathing and when accompanied with a pulseless state the patient should be considered to be in full cardiopulmonary arrest

 

Pediatric D10 Dosing - See I-20 Pediatric Medication Doses

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1:10,000 = 0.1mg/mL

1:1000 = 1mg/mL

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Link - SO-P-40