Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia

Section 7 - PEDIATRIC / OBSTETRICAL

7.03 PEDIATRIC VENTRICULAR FIBRILLATION /PULSELESS VENTRICULAR TACHYCARDIA

• Initiate 5 cycles of high quality (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.
• Maintain rate of between 100-120 compressions per minute.
• Maintain compression depth of at least 1/3 of the depth of the chest.
• Allow for complete chest recoil between compressions.
• Minimize interruptions
• Assist ventilations with OXYGEN @ 100% via BVM. DO NOT HYPERVENTILATE
• INTUBATE and establish peripheral IV or IO line as able.
• DEFIBRILLATION @ 2 J/kg.
  • Proceed to next step only if V-Fib / Pulseless V-Tach persists.
  • If rhythm converts, follow appropriate Practice Parameters.

Refer to Handtevy System for specific medication administration based on weight / length.

• 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 every 3 - 5 minutes of continued arrest.

• DEFIBRILLATION @ 4 J/kg. Continue CPR immediately.
• If rhythm converts, follow appropriate Practice Parameters.

• If hypovolemia suspected, fluid bolus 20 ml / kg.
• AMIODARONE 5 mg/kg, IVP or IO - refer to Broselow Tape for patient specific dose.

OR

• LIDOCAINE 1.0 mg/kg IV / IO.

• DEFIBRILLATION @ 6 J/kg. Continue CPR immediately.
• If rhythm converts, follow appropriate Practice Parameters

• After 10 minutes, LIDOCAINE 1.0 mg/kg IV / IO.
• DEFIBRILLATION @ 8 J/kg. Continue CPR immediately.
• If rhythm converts, follow appropriate Practice Parameter

If V-Fib converts to a pulse-producing tachycardic rhythm, follow with LIDOCAINE boluses IVP.