Doses/Details CPR Quality Pediatric Cardiac Arrest * Push hard (≥⅓ of Shout for Help/Activate Emergency Response posterior diameter of chest) and fast (at least 100/min) and allow complete chest recoil. 1 * Minimize interruptions in compressions. *Avoid excessive ventilation Legend * Rotate compressor every 2 EMT minutes * If not advanced airway, 15:2 A EMT-A A compression-ventilation P EMT-P P If advanced airway, 8-10 M MC Order M breaths per minute with Yes No continuous chest Rhythm compressions. Shockable? Shock Energy for Defibrillation First shock 2 J/kg, second shock 4 J/kg, subsequent shocks J/kg, maximum 10 ≥4 J/kg or adult dose. Drug Therapy *Epinephrine IO/IV Dose Shock 0.01 mg/kg (0.1 mL/kg of 1:10,000 concentration). Repeat every 3-5 minutes. If no IO/IV access, may give endotracheal dose: 0.1mg/kg (0.1 mL/kg of 1:1000 concentration). No *Amiodarone IO/IV Dose: 5 mg/kg bolus during cardiac arrest. May repeat up to 2 Rhythm times for refractory Shockable? VF/pulseless VT. Advanced Airway Yes *Endotracheal intubation or supraglottic advanced airway. Shock *Waveform Capnography or capnometry to confirm and monitor ET tube placement *Once advanced airway in place give 1 breath every 6-8 seconds (8-50 breaths per minute) Return of Spontaneous Rhythm Yes Circulation (ROSC) Shockable? and blood pressure *Spontaneous arterial pressure waves with Rhythm monitoring Reversible Causes Shockable? -Hypovolemia Yes -Hypoxia Shock -Hydrogen ion (acidosis) -Hypoglycemia -Hypo-/hyperkalemia Yes Rhythm -Tension pneumothorax Shockable? -Toxins -Thrombosis, pulmonary -Thrombosis, coronary -Trauma
Doses/Details CPR Quality * Push hard (≥⅓ of diameter of chest) and fast (at least 100/min) and allow complete chest recoil. * Minimize interruptions in compressions. *Avoid excessive ventilation * Rotate compressor every 2 minutes * If not advanced airway, 15:2 compression-ventilation If advanced airway, 8-10 breaths per minute with continuous chest compressions. Shock Energy for Defibrillation First shock 2 J/kg, second shock 4 J/kg, subsequent shocks ≥4 J/kg, maximum 10 J/kg or adult dose. Drug Therapy *Epinephrine IO/IV Dose 0.01 mg/kg (0.1 mL/kg of 1:10,000 concentration). Repeat every 3-5 minutes. If no IO/IV access, may give endotracheal dose: 0.1mg/kg (0.1 mL/kg of 1:1000 concentration). *Amiodarone IO/IV Dose: 5 mg/kg bolus during cardiac arrest. May repeat up to 2 times for refractory VF/pulseless VT. Advanced Airway *Endotracheal intubation or supraglottic advanced airway. *Waveform Capnography or capnometry to confirm and monitor ET tube placement *Once advanced airway in place give 1 breath every 6-8 seconds (8-50 breaths per minute) Return of Spontaneous Circulation (ROSC) and blood pressure *Spontaneous arterial pressure waves with monitoring Reversible Causes -Hypovolemia -Hypoxia -Hydrogen ion (acidosis) -Hypoglycemia -Hypo-/hyperkalemia -Tension pneumothorax -Toxins -Thrombosis, pulmonary -Thrombosis, coronary -Trauma Pediatric Cardiac Arrest Shout for Help/Activate Emergency Response Legend EMT A EMT-A A P EMT-P P M MC Order M 1 Rhythm Shockable? Yes No Shock No Rhythm Shockable? Yes Shock Rhythm Shockable? Yes Rhythm Shockable? Yes Shock Rhythm Shockable? Yes posterior
ems_protocols.3.21a.docx