Pediatric Asystole
Section 7 - PEDIATRIC / OBSTETRICAL
7.01 PEDIATRIC ASYSTOLE
CONSIDER MEDICAL ETIOLOGY OF ASYSTOLE AND REFER TO APPROPRIATE PRACTICE PARAMETER:
- Hypoxia / Acidosis, INITIAL MEDICAL CARE (2.01)
- Injuries, CHEST INJURIES (6.04)
- Suffocation caused by a foreign body, FBAO (3.03)
- Smoke inhalation, BURNS (6.02)
- SIDS
- Sepsis / Hypovolemia, SHOCK (5.13)
- Hypothermia, COLD EMERGENCIES (5.06)
- Initiate 5 cycles of (30:2) one-rescuer or (15:2) two-rescuer CPR for approximately 2 minutes to allow blood to circulate and continue throughout resuscitation, minimizing interruptions. Assist ventilations with OXYGEN @ 100% via BVM. DO NOT HYPERVENTILATE
- If hypothermic, refer to COLD EMERGENCIES (5.06)
- INTUBATE and establish peripheral IV or IO line as able
- If hypovolemia suspected, fluid bolus 20 ml/kg
Refer to Handtevy System for medication administration
- EPINEPHRINE 1:10,000 (0.1 mg/ml) 0.01 mg/kg IV / IO
- Repeat EPINEPHRINE 1:10,000 (0.1 mg/ml) 0.01 mg/kg IV / IO, every 3-5 minutes of continued arrest
- ATROPINE SULFATE 0.02 mg/kg (minimum dosage is 0.1 mg)
- Repeat every 3-5 minutes of continued arrest for maximum dose of 1 mg
Ventilation and oxygenation always precede drug therapy.
| The current national guidelines do not include ATROPINE for treatment of TRUE ASYSTOLE as there is no proof it has a therapeutic benefit. Under the Seminole County Practice Parameters the use of ATROPINE SULFATE is indicated in cardiac arrest that may be caused by extreme bradycardia/hypotension.
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