Bradycardia (Pediatric)

Question 1

Bradycardia (Pediatric):

At what (heart) rate, with signs of poor perfusion, should the provider begin chest compressions?

Answer 1

Less than 60 bpm (<60)

Question 2

Bradycardia (Pediatric):

Subsequent to IV access, what is the first (primary) medication, and dosage, for symptomatic pediatric bradycardia?
Should this medication be repeated?

Answer 2

Epinephrine (1:10,000) 0.01 mg/kg up to 0.5 mg IV or IO.

Repeat epinephrine every 3–5 minutes while patient is symptomatic.

Question 3

Bradycardia (Pediatric):

What is the second line medication, and dose, for symptomatic pediatric bradycardia?

(subsequent to epinephrine)

Answer 3

Atropine 0.02 mg/kg IV or IO. (Minimum dose 0.1 mg, maximum dose 1.0 mg.)

repeat atropine dose once if patient remains symptomatic

Question 4

Bradycardia (Pediatric):

If the pediatric patient remains symptomatic, subsequent to epinephrine and atropine, what appropriate action should the paramedic take next?

Answer 4

Infuse 20 ml/kg bolus of NS IV or IO.