Advanced Airway prn +Vascular Access
*Begin consideration of underlying causes
P waves present, upright
Rate variability c movement
Infant rate <220
Child rate <180
Variable RR
Constant PRI
P waves absent/abnormal
No rate variability
Infant rate >220
Child rate >180
Constant RR
0.5-1 J/kg
2J/kg if ineffective
Sedate if possible without cardioversion delay.
Amiodarone
IV/IO: 5mg/kg
(max 15mg/kg)
Lidocaine
IV/IO/ETT: 1mg/kg
(max 3mg/kg)
Procainamide
IV/IO: 15mg/kg/30 min
(max 17 mg/kg)
Fever
Dehydration
Pain
Hypoxemia
Pneumothorax
Toxins
Thrombus
if immediate.
0.5-1 J/kg
2J/kg if ineffective
Sedate if possible without cardioversion delay.
Adenosine (Rapid IV/IO):
0.1mg/kg max 6mg dose 1
0.2mg/kg max 12mg dose 2
Amiodarone
IV/IO: 5mg/kg
(max 15mg/kg)
Procainamide
IV/IO: 15mg/kg/30 min
(max 17 mg/kg)
Hypoxemia: Oxygenate/ventilate
Hypovolemia: Isotonic fluids 20 ml/kg over 10 minutes, assess and repeat, prn.
Hyperthermia:
Isotonic Fluids 10-20ml/kg max 40-60 ml/kg to pt condition
Fever >102 core
PO/PR Acetamenophen 15 mg/kg
Exhaustion: 103 core, mentation okay
Stroke: Exhaustion with >105 core and altered mentation
Diabetic/Glucose Emergencies
Hypoglycemia
Dextrose Administration
Neonates: 0-1 month: D10 @2ml/kg slow IV/IO
Infants: 1mo-1, 2 y/o: D25 @2ml/kg slow IV/IO
Children 2-8y/o: D50 @25g slow IV/IO
Hyperglycemia
Isotonic Fluids 10-20ml/kg max 40-60 ml/kg to pt condition
Hypothermia:
Mild: 93-95 core temp: increase cabin warmth
Moderate: 86-93 core temp: Heat to groin, armpits, 3 shock max, longer intervals between drugs, warm fluids
Severe: <86 core temp: 3 shock max until temp rises, CPR, no drugs until moderate category.
Hyperkalemia: Calcium cholride slow bolus IV/IO: 10% solution 20mg/kg
Hypoglycemia: Administer dextrose
Toxicity:
TCA: Sodium Bicarbonate slow IV/IO: 1mEq/kg
Others: Poison Control Center for direction.