PEDS

Asystole or PEA

Algorithm

New UPDATED 10/1/2021

Initiate or maintain CPR
► High-flow oxygen by BVM

►IV / IO vascular access without interruption of CPR


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

Consider

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

→ If known diabetic and hypoglycemia suspected, administer:
Dextrose 10% 5 mL/kg IVPB / IO (See Dosing / Age Chart Below) - Max of 250 mL


If at any time develops rhythm with pulse:

Make BHC (CCERC preferred) 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