CARDIAC EMERGENCY 114 Post Resuscitation Assessment Completion of arrhythmia treatment Oxygen 100% and airway maintenance appropriate to the patient’s condition Supportive care EMT STOP IV NS TKO Assess BP If systolic <90 mmHg administer 250 ml NS (peds systolic BP 70 + 2x age, 20 – cc/kg bolus) repeat until BP >90 mmHg or appropriate for pediatric age. Check blood sugar, if low titrate dextrose 50% prn slowly until normal levels achieved. Try to avoid large swings in serum glucose levels (peds see glucose dosing chart) – Raise head of bed 30° AEMT STOP 12 Lead EKG, transmit Ensure head of bed is raised 30° Medications: If anti-arrhythmic administered: Amiodarone 300mg IV (peds 5 mg/kg , may repeat x 2), if one dose given and – arrhythmia persists, give second dose 150 mg If Lidocaine administered, start infusion drip at 2-4 mg/min (peds 20-50 – mcg/kg/min) Continue ventilatory support to maintain Respirations <12 ideally (peds infant-preschool min respiratory rate should be 30. – school age min respiratory rate should be 20) – Initiate Induced Hypothermia protocol if appropriate Treatment - Protocol If patient does not tolerate ET tube, contact Medical Control for: Valium 2-10 mg (peds 0.1 mg/kg) or Versed 2-5 mg IV (peds 0.1 mg/kg) for patient sedation. Use soft restraints if necessary for patient safety (to prevent extubation) Note:
CARDIAC EMERGENCY 114 Post Resuscitation Assessment Completion of arrhythmia treatment Oxygen 100% and airway maintenance appropriate to the patient’s condition Supportive care EMT STOP IV NS TKO Assess BP – If systolic <90 mmHg administer 250 ml NS (peds systolic BP 70 + 2x age, 20 cc/kg bolus) repeat until BP >90 mmHg or appropriate for pediatric age. Check blood sugar, if low titrate dextrose 50% prn slowly until normal levels achieved. Try to avoid large swings in serum glucose levels (peds – see glucose dosing chart) Raise head of bed 30° AEMT STOP 12 Lead EKG, transmit Ensure head of bed is raised 30° Medications: If anti-arrhythmic administered: Amiodarone – 300mg IV (peds 5 mg/kg , may repeat x 2), if one dose given and arrhythmia persists, give second dose 150 mg If Lidocaine administered, start infusion drip at 2-4 mg/min (peds – 20-50 mcg/kg/min) Continue ventilatory support to maintain Respirations <12 ideally (peds – infant-preschool min respiratory rate should be 30. school age – min respiratory rate should be 20) Initiate Induced Hypothermia protocol if appropriate Treatment - Protocol If patient does not tolerate ET tube, contact Medical Control for: Valium 2-10 mg (peds 0.1 mg/kg) or Versed 2-5 mg IV (peds 0.1 mg/kg) for patient sedation. Note: Use soft restraints if necessary for patient safety (to prevent extubation)
Tennessee-Guideline-07282016.docx