Cardiac Arrest (Pediatric) - ALS Rhythms: Flashcards
Cardiac Arrest (Pediatric) - ALS Rhythms:
If a shockable rhythm is identified, what is the correct initial (first) dosage of electricity, for defibrillation, for pediatric patients?
Defibrillate at 1 – 2 J/kg
Cardiac Arrest (Pediatric) - ALS Rhythms:
If a shockable rhythm is still identified, what is the correct dosage of electricity for a subsequent defibrillation, for pediatric patients?
Defibrillate x 1 – 4 J/kg
Cardiac Arrest (Pediatric) - ALS Rhythms:
➢ What is the first medication, and dose, administered during a pediatric cardiac arrest?
➢ According to the ACLS algorithm, when should this medication be administered.
➢ Epinephrine 1:10,000 0.01 mg/kg (repeated 4 times; max. of 5)
➢ Epinephrine is given after the SECOND defibrillation;/’
Cardiac Arrest (Pediatric) - ALS Rhythms:
What is the maximum number of epinephrine doses you can administer secondary to cardiac arrest?
Total of 5 doses
Cardiac Arrest (Pediatric) - ALS Rhythms:
What is the criteria do discontinue resuscitation efforts secondary to pediatric cardiac arrest?
➢ 25 Minutes (or longer) of High Performance CPR
➢ EtCO2 reading less than 10
Cardiac Arrest (Pediatric) - ALS Rhythms:
➢ When considering H’s and T’s, what is the correct dosage of Calcium Gluconate?
➢ What is the reason Calcium Gluconate is administered?
➢ 50 mg/kg, Calcium Gluconate
➢ Hyperkalemia (High levels of potassium)
Cardiac Arrest (Pediatric) - ALS Rhythms:
When considering H’s and T’s, how is hyperkalemia identified via 12-lead EKG?
➢ Small, rounded P-Waves
➢ Prolonged PR-Interval
➢ Tall, tented T-Wave
➢ ST-Segment depression minimal
Cardiac Arrest (Pediatric) - ALS Rhythms:
➢ When considering H’s and T’s, what is the correct dosage of Sodium Bicarbonate 1 mEq/kg
➢ What is the reason Sodium Bicarbonate is administered?
➢ 1 mEq/kg, Sodium Bicarbonate
➢ Counteract hyperkalemia
➢ Counteract acidosis
dead patients don’t breathe and become acidotic
Cardiac Arrest (Pediatric) - ALS Rhythms:
➢ For non-shockable rhythms, what is the pediatric dose for normal saline you should administer?
➢ Can the dose be repeated?
➢ 20 ml/kg
➢ Yes, the dose may be repeated ONCE
Cardiac Arrest (Pediatric) - ALS Rhythms:
What is the immediate course of action if the pediatric cardiac arrest is unwitnessed by EMS personnel?
If arrest not witnessed by EMS then 5 cycles of CPR prior to 1st defibrillation.
Cardiac Arrest (Pediatric) - ALS Rhythms:
What are the two main keys to successful resuscitation?
➢ Effective CPR
➢ Prompt defibrillation
Cardiac Arrest (Pediatric) - ALS Rhythms:
➢ What is recurrent ventricular fibrillation/tachycardia?
➢ How is recurrent ventricular fibrillation/tachycardia treated?
➢ Recurrent ventricular fibrillation/tachycardia is defined as SUCCESSFULLY CONVERTED by standard defibrillation techniques (i.e. 4 J/kg), but subsequently returns.
➢ It is managed by treatment of correctable causes and use of anti-arrhythmic medications in addition to standard defibrillation.
Cardiac Arrest (Pediatric) - ALS Rhythms:
➢ What is refractory ventricular fibrillation/tachycardia?
➢ How is refractory ventricular fibrillation/tachycardia treated?
➢ Refractory ventricular fibrillation/tachycardia is defined as NOT CONVERTED by standard defibrillation.
➢ If standard defibrillation and anti-arrhythmic medications fail to produce a response, change the pad placement/vector with a new set of pads.
Cardiac Arrest (Pediatric) - ALS Rhythms:
In the event polymorphic V-Tach (Torsades de Pointes) is suspected, what is the appropriate medication and dose to administer?
Magnesium sulfate 25-50mg/kg IV/IO.
Cardiac Arrest (Pediatric) - ALS Rhythms:
What medications and dosages are appropriate for a pediatric patient suspected of cardiac arrest secondary to renal failure/dialysis?
➢ Calcium Gluconate 50 mg/kg (up to 1 gm) IV/IO
➢ Sodium Bicarbonate 1 meq/kg (up to 50 meq) IV/IO
- treating for hyperkalemia*
- MUST USE SEPARATE IV LINES
