PEDS
V-Fib or Pulseless V-Tach / Wide Complex Tach
Algorithm
New UPDATED 10/01/2021
Initiate or continue CPR and when defibrillator available:
â–ºDefibrillate once at
Zoll (2 j/kg)
Lifepack (2j/kg)
Philips (2 j/kg)
â–¼
Maintain CPR approximately 2 minutes
→ High-flow oxygen by BVM, IV/IO without interruption of CPR
â–¼
â–ºDefibrillate once at
Zoll (4 j/kg)
Lifepack (4 j/kg)
Philips (4 j/kg)
â–¼
Maintain CPR 2 min
â–ºEpinephrine 0.01 mg/kg IV / IO (0.1 mg/mL), repeat every 3 min
â–¼
Maintain CPR 2 min.
â–ºDefibrillate once at
Zoll (4 j/kg)
Lifepack (4 j/kg)
Philips (4 j/kg)
â–¼
Maintain CPR 2 min.
â–ºAmiodarone 5 mg/kg IV / IO, may repeat 5 mg/kg IV/IO in 5 and 10 min
or
â–ºLidocaine 1 mg/kg IV / IO, max dose of 100 mg, one time only
â–¼
Maintain CPR 2 min.
â–ºDefibrillate once at
Zoll (4 j/kg)
Lifepack (4 j/kg)
Philips (4 j/kg)
â–¼
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
​