PEDS
Asystole or PEA
Algorithm
Initiate or maintain CPR
► High-flow oxygen by BVM
▼
►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
▼
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)
▼
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
1:10,000 = 0.1mg/mL
1:1000 = 1mg/mL