Aha pediatric tachycardia

Question 1

Step one

Answer 1

Identify and treat underlying cause

1. Maintain patent airway ; assist breathing as neccesary
2. oxygen
3. cardiac monitor to identify rhythm; monitor blood preasure and oximitry
4. Io/iv access
5. 12 lead ecg

Question 2

Step two

Answer 2

evaluate qrs duration

• Is it narrow( less than or equall to .09) or wide ( greater than .09)

Question 3

step 3

Answer 3

evaluate rhythm with 12 lead

Question 4

step 4

Answer 4

Is it probable sinus tachycardia?

1. compatible history consistant with known cause?
2. p waves present and normal?
3. variable r- r and consistant pr intervals
4. Infant rate usualy less than 220 / min
5. Pedi rate usualy less than 180/ min

Question 5

step 6

Answer 5

search for and treat cause

Question 6

step 7

Answer 6

consider vagal manuevers

Question 7

Step 8

Answer 7

if iv/io acess present give adenosine

or

If ivio not present / adenosine ineffective- syncronized cardio vert

Question 8

step 9

Answer 8

?posible ventricular tachycardia?

signs of cardiovascular compramise?

1. hypotension
2. acuteley altered mental status
3. sighns of shock?

Question 9

Step 10

Answer 9

syncronized cardioversion

Question 10

Step 11

Answer 10

consider adenosine if rhythem is regular and qrs is monomorphic

Question 11

expert consultation advised for

Answer 11

amiodarone

Question 12

Cardioversion dose

Answer 12

• Begain with .5-1 J/kilo
• If not affective increase to 2 j / kilo
• Sedate if needed but do not delay cardioversion

Question 13

Adenosine dose

Answer 13

• .1mg / kg rapid bolus w/ max of 6 mg
• second dose is .2 mg/ kg rapid bolus w/ max dose of 12 mg

Question 14

Amiodarone dose

Answer 14

5 mg /kg over 20-60 minutes