Pediatric Pulseless Electrical Activity PEA

Section 7 - PEDIATRIC / OBSTETRICAL

7.02 PEDIATRIC PULSELESS ELECTRICAL ACTIVITY (PEA)

CONSIDER MEDICAL ETIOLOGY OF PEA AND REFER TO APPROPRIATE PRACTICE PARAMETER:

• Hypoxia / Acidosis, INITIAL MEDICAL CARE (2.01).
• Hypovolemia, SHOCK (5.13).
• Tension Pneumothorax, CHEST INJURIES (6.04).
• 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
• 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 (0.1mg/ml) 0.01 mg/kg IV / IO
• Repeat EPINEPHRINE 1:10,000 (0.1mg/ml) 0.01 mg/kg IV / IO, every 3-5 minutes of continued arrest.

If P.E.A. rate < 60 complexes per minute,

• ATROPINE SULFATE 0.02 mg/kg, (minimum dosage is 0.1 mg)
• REPEAT every 3-5 minutes of continued arrest for a maximum dose of 1 mg

Ventilation and oxygenation always precede drug therapy