PEDS

V-Fib or Pulseless V-Tach / Wide Complex Tach

Algorithm

 

Initiate or continue CPR and when defibrillator available:

Defibrillate once at 2 J/kg Philips / Zoll (2 J/kg)


Maintain CPR approximately 2 minutes

→ High-flow oxygen by BVM, IV/IO without interruption of CPR

Defibrillate once at 4 J/kg Philips / Zoll (2 J/kg)


Maintain CPR 2 min

Epinephrine 0.01 mg/kg IV / IO (0.1 mg/mL), repeat every 3 min

Maintain CPR 2 min.
Defibrillate once at 4 J/kg Philips / Zoll (2 J/kg)


Maintain CPR 2 min.

Amiodarone 5 mg/kg IV / IO, may repeat 5 mg/kg IV/IO in 5 and 10 min

Maintain CPR 2 min.
Defibrillate once at 4 J/kg Philips / Zoll (2 J/kg)

Continue CPR, Epinephrine, Defibrillation, and Amiodarone.

D10 25 gm/250 mL (50% 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

 

BHC:

For further orders, or
To request pronouncement of patient in the field

 

Interruption of chest compressions should always be held to a minimum.
Pads can be placed in the antero-lateral and antero-posterior positions; either pad placement is acceptable

(As long as they don’t touch).
For implanted pacemaker/defibrillator place pads to either side and not directly on top of the implanted device. For medication patch: remove patch, wipe area clean before attaching an electrode pad.

1:10,000 = 0.1mg / 1mL

1:1000 = 1mg / 1mL

Call

M: 949-769-1162

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