Peds Bradycardia with a Pulse Flashcards
What is the biggest single different action that is considered in Peds Bradycardia with a Pulse that is NOT really a thing with Adult Bradycardia
CPR! You actually do chest compressions if the HR is below a certain rate! And start bradycardia meds. Next card for that specific rate.
Is peds HR remains below ____ despite oxygenating and ventilating, you start CPR and start
60 bpm!
Other than a bradycardic HR threshold that prompts CPR, what is the other big theme with Peds Bradycardia with a Pulse that prompts certain interventions?
The initial emphasis on ensuring OXYGENATION and VENTILATION are adequate to prevent the need for Chest Compressions!
So the FIRST consideration is if the kid is hemodynamically UNSTABLE and bradycardic, the first things you do is SUPPORT ABC’s by maintaining a patent airway (INTUBATE, etc.) and ventilating, etc as needed to see if you can get HR back to > 60 bpm quickly. And obviously you put on all the MONITORS and get an EKG
The SECOND consideration comes in if HR remains > 60 bpm, in which you’ll start CHEST COMPRESSIONS
What are the 3 biggest culprits for Peds Bradycardia with a Pulse
1) HYPOXIA - hence the increased emphasis on oxygenation and ventilation
2) Hypothermia
3) Medications
When doing chest compressions for HR < 60, how often do you check a pulse?
What do you do if you lose a pulse?
q2min pulse checks, just the same as for PALS cardiac arrest
If you lose a pulse, you go to the Peds Cardiac Arrest algorithm!
Epi doses for Peds Bradycardia with a pulse
10 mcg/kg IV/IO, 100 mcg/kg through ETT (so 10x the IV dose)
0.01 mg/kg (0.1 mL/kg of the 0.1 mg/mL concentration).
Repeat every 3-5 minutes.
If IV/IO access not available but endotracheal (ET) tube in place, may give ET dose: 0.1 mg/kg (0.1 mL/kg of the 1mg/mL concentration
Atropine doses for Peds Bradycardia with a pulse
20mcg/kg, minimum dose 0.1mg (so minimum 0.25mL of the 0.4mg/mL vials)
Max 0.5 mg (so basically one 0.4mg/mL vial)
may REPEAT ONCE
What are the other two treatments/interventions for peds bradycardia with a pulse other than Epi and Atropine
Transthoracic Pacing
Transvenous Pacing
