PEDS
Asystole or PEA
Algorithm
New UPDATED 10/1/2021
Initiate or maintain CPR
► High-flow oxygen by BVM
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►IV / IO vascular access without interruption of CPR
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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
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→ Correct possible reversible causes:
hypovolemia, acidosis hypoxia, tension pneumothorax, hypothermia, toxins
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Consider
►Normal Saline 20 mL/kg bolus, may repeat twice to attain and maintain perfusion
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→ If known diabetic and hypoglycemia suspected, administer:
►Dextrose 10% 5 mL/kg IVPB / IO (See Dosing / Age Chart Below) - Max of 250 mL
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If at any time develops rhythm with pulse:
Make BHC (CCERC preferred) for transport destination
For continued PEA or asystole:
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→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