PEDS

Asystole or PEA

Algorithm

New UPDATED 4/1/2020

Initiate an organized approach to CPR with responders in designated positions

 

 

 

Continue High Quality CPR without interruption unless pulse obtained

Witnessed Arrest - Consider passive ventilation for 6 min.

Un-witnessed Arrest - BVM / ETCO2 or Supraglottic airway unless:

ET indicated (Laryngeal edema from smoke inhalation)

Continue compression for approx. 2 min., then reassess

 

►IV/IO vascular access without interruption of CPR

PEA

20 mL/kg NS bolus, may repeat twice to attain and maintain perfusion

→ Correct possible reversible causes:

Hypovolemia, acidosis, hypoxia, tension pneumothorax, hypothermia, toxins

PEA / ASYSTOLE

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


D10 25 gm/250 mL (10% solution) IVPB / IO

If diabetic and hypoglycemia suspected: (No D-stick, Non-Traumatic FA)

Epinephrine can be given with D10, there is no negative reaction


Advanced Airway with minimal interruption of CPR after 4-6 min of CPR

If prior to transport the pt develops a rhythm with pulse:
Make BHC and transport to available Cardiovascular Receiving Center (CVRC)


For continued PEA or Asystole:

→ Maintain CPR and transport to nearest PRC or make Base contact to:

Provide further resuscitation orders
If appropriate, 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

 

→If Base Hospital orders Push-Dose Epinephrine for refractory hypotension, refer to Push-Dose Epinephrine procedure

 

Pediatric D10 Dosing - See I-20 Pediatric Medication Doses

1:10,000 = 0.1mg/mL

1:1000 = 1mg/mL

Call

M: 949-769-1162

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