Pulseless arrest (peds)
This page is for pediatric patients. For adult patients, see: pulseless arrest. See critical care quick reference for drug doses and equipment sizes by weight.
Asystole and PEA
- Give Epi 0.01mg/kg (0.1 mL/kg 1:10,000) (max 1mg) q3-5min
- Rhythm check q2min
- Prioritize adequate oxygenation and ventilation, as respiratory arrest is the most common cause of pediatric cardiac arrest
- Consider H's and T's
- Hypoglycemia
- Hypovolemia
- Hypoxia (most common cause of pediatric arrest)
- Hydrogen ion
- Hypokalemia or hyperkalemia
- Hypothermia
- Tension pneumothorax
- Tamponade
- Toxins
- Thrombosis, pulmonary
- Thrombosis, coronary
Ventricular fibrillation/Pulseless Ventricular Tachycardia
- Shock as quickly as possible and resume CPR immediately
- First shock 2 J/kg
- Second shock 4 J/kg
- Subsequent shocks ≥ 4 J/kg (max 10 J/kg)
- Give Epi if (shock + 2min CPR) fails to convert rhythm
- Perform pulse check/shock if appropriate q2min
- Give antiarrhythmic if (2nd shock + 2min CPR) again fails
- 1st line: Amiodarone
- 5mg/kg (max 300mg)
- May repeat twice up to 15mg/kg
- 2nd line: Lidocaine
- 1mg/kg
- Magnesium
- 25-50mg/kg (max 2g) IV
- Only for polymorphic V-tach
- 1st line: Amiodarone
See Also
- PALS (Main)
- Adult Pulseless Arrest
- Post Cardiac Arrest
- Brain Death
- Critical care quick reference
References
AHA 2010 Guidelines for PALS
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