9 - Pediatrics - Bradycardia

Question 1

Physical examination of the pediatric bradycardic patient may find:

Answer 1

• weak/thready/absent peripheral pulses
• decreased consciousness
• tachypnea/respiratory distress
• central cyanosis/cool skin
• hypoTN (late sign)

Question 2

CPR MUST be performed if the pediatric patient’s HR is under ________.

Answer 2

60 BPM

Question 3

If, despite proper oxygenation and perfusion, bradycardia persists, the patient should be given ______.

A. 0.01 mg/kg 1:10,000 epi IV/IO
B. 0.01 mg/kg 1:1,000 epi IV/IO
C. Atropine 0.02 mg/kg IV/IO
D. 20 mL/kg NS IV/IO

Answer 3

A. 0.01 mg/kg 1:10,000 epi IV/IO

INCORRECT:
B. 0.01 mg/kg 1:1,000 epi IV/IO - this is the formulation for anaphylaxis

C. Atropine 0.02 mg/kg IV/IO - this is used in increased vagal tone/AV block

D. 20 mL/kg NS IV/IO - this is last line for hypoTN after the bradycardia is corrected

Question 4

When is TCP allowed in the pediatric bradycardia patient?

Answer 4

When CPR, oxygenation, and ACLS meds (epi/atropine) do not help with cardiac compromise.