PEDS

Bradycardia

Algorithm

 

Symptomatic or deteriorating bradycardia:


► High-flow oxygen by Mask or Nasal Cannula, assist with BVM as needed

If pulse rate < 60/minute and unresponsive with signs of poor perfusion, initiate CPR.


Establish IV access

20 mL/kg NS bolus, if signs of hypovolemia or dehydration suspected

Base Hospital Contact

Or
If no evidence of hypovolemia

Epinephrine 0.01 mg/kg IV / IO (0.1 mg/mL)


Base Hospital Contact

Continued signs of poor perfusion

Initiate Transcutaneous Pacing

 

 

Symptomatic bradycardia is a heart rate < 60 BPM and:

Signs of poor perfusion (hypotension, poor skin signs, ALOC, or SOB).

 

Deteriorating bradycardia is a heart rate < 60 BPM and:
Decreasing heart rate with time (ie: drop in rate from 60 to 50 over a few min., despite O2).

 

High flow O2 by mask or assist ventilations as necessary.
 

If pulse rate < 60/minute and unresponsive with signs of poor perfusion, initiate CPR.

 

BHO - Pacing, Versed, and Heart transplant patients (may not respond effectively to resuscitation drugs.)

 

1:10,000 = 0.1mg/mL

1:1000 = 1mg/mL

Call

M: 949-769-1162

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