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PEDS

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

Algorithm

New UPDATED 10/01/2021

Initiate or continue CPR and when defibrillator available:

Defibrillate once at

Zoll (2 j/kg)

Lifepack (2j/kg)

Philips (2 j/kg)


Maintain CPR approximately 2 minutes

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

Defibrillate once at 

Zoll (4 j/kg)

Lifepack (4 j/kg)

Philips (4 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

Zoll (4 j/kg)

Lifepack (4 j/kg)

Philips (4 j/kg)


Maintain CPR 2 min.

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

or

Lidocaine 1 mg/kg IV / IO, max dose of 100 mg, one time only

Maintain CPR 2 min.
Defibrillate once at

Zoll (4 j/kg)

Lifepack (4 j/kg)
Philips (4 j/kg)


Continue CPR, Epinephrine, Defibrillation, and Amiodarone.

BHC:

For further orders (CCERC preferred), 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

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