Bradycardia Algorithm Legend EMT A EMT-A A P EMT-P P M MC M Pediatric Bradycardia With a and Poor Perfusion Identify and treat underlying cause patient airway; assist breathing as necessary ●Maintain ●Oxygen A monitor to identify rhythm; monitor blood pressure and oximetry A ●Cardiac access ●IO/IV ECG if available; don’t delay therapy ●12-Lead No Cardiopulmonary Yes Compromise ●Hypotension altered mental status ●Acutely of shock ●Signs ABC’s ●Support oxygen ●Give ●Observe expert ●Consider Doses/Details consultation Epinephrine IO/IV Dose: 0.01 mg/kg (0.1 mL/kg of No Yes 1:10,000 concentration). Repeat every 3-5 minutes. If IO/IV access not available but ●Epinephrine endotracheal (ET) tube in for increased vagal tone or primary AV block ●Atropine place, may give ET dose: 0.1 transthoracic pacing/transvenous pacing ●Consider mg/kg (0.1 mL/kg of 1:1000). underlying causes ●Treat Atropine IO/IV Dose: 0.02 mg/kg. May repeat once. Minimum dose 0.1 mg and maximum single dose 0.5 mg. If pulseless arrest develops, go to Cardiac Arrest Algorithm Tachycardia Algorithm Legend EMT Pediatric Tachycardia A EMT-A A With a Pulse and Poor Perfusion P EMT-P P M MC M
Legend EMT A EMT-A A P EMT-P P M MC M Bradycardia Algorithm Pediatric Bradycardia With a and Poor Perfusion A Identify and treat underlying cause ●Maintain patient airway; assist breathing as necessary ●Oxygen ●Cardiac monitor to identify rhythm; monitor blood pressure and oximetry ●IO/IV access ●12-Lead ECG if available; don’t delay therapy A Cardiopulmonary Compromise ●Hypotension ●Acutely altered mental status ●Signs of shock Doses/Details Epinephrine IO/IV Dose: 0.01 mg/kg (0.1 mL/kg of 1:10,000 concentration). Repeat every 3-5 minutes. If IO/IV access not available but endotracheal (ET) tube in place, may give ET dose: 0.1 mg/kg (0.1 mL/kg of 1:1000). Atropine IO/IV Dose: 0.02 mg/kg. May repeat once. Minimum dose 0.1 mg and maximum single dose 0.5 mg. No ●Support ABC’s ●Give oxygen ●Observe ●Consider expert consultation Yes No ●Epinephrine ●Atropine for increased vagal tone or primary AV block ●Consider transthoracic pacing/transvenous pacing ●Treat underlying causes If pulseless arrest develops, go to Cardiac Arrest Algorithm Yes Legend EMT A EMT-A A P EMT-P P M MC M Tachycardia Algorithm Pediatric Tachycardia With a Pulse and Poor Perfusion
2012_lc_ems_protocols.docx