View source for 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 [[Medical Gases|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|EPINEPHRINE]] 1:10,000 (0.1mg/ml) 0.01 mg / kg IV /IO
* Repeat [[Epinephrine|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.
* [[Antiarrhythmics|AMIODARONE]] 5 mg/kg, IVP or IO - refer to Broselow Tape for patient specific dose.
:'''OR'''
* [[Antiarrhythmics|LIDOCAINE]] 1.0 mg/kg IV / IO.


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


* After 10 minutes, [[Antiarrhythmics|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 [[Antiarrhythmics|LIDOCAINE]] boluses IVP.'''''

[[Category:Pediatric and Obstetrical|0703]]