13 - Pediatrics - WCT

Question 1

What other interventions for the wide complex tachycardia peds patient may be utilized (aside from chemical and electrical cardioversion)?

Answer 1

• Vagal stimulation of infants/children by ice to face.

- Valsalva maneuver of older children

Question 2

A QRS with a duration greater than ____ is considered a wide complex.

Answer 2

120 ms (0.12 s)

Question 3

Synchronized cardioversion of the unstable pediatric patient with WCT.

Answer 3

1 J/kg

2 J/kg

Question 4

Signs of cardiopulmonary compromise in the pediatric WCT patient.

Answer 4

From head to toe:

• ALOC
• tachypnea/respiratory difficulty
• central cyanosis
• absent/weak/thready peripheral pulses
• hypoTN

Question 5

If there is no change in the condition of a pediatric WCT patient following attempted electrical cardioversion, contact medical control and stand by for orders for ______.

What’s the drip rate for this?

Answer 5

1 mg/kg IO/IO lidocaine over 20-60 min

OR

1.5 mg/kg IV/IO procainamide over 30-60 minutes

Calculating drip rates:

(1mg/kg)(weight in kg)(1 mL/x mg)(60gtt/1mL) then figure out in seconds