Access ABCs
Secure Airway
Administer 100% Oxygenation
Access Vital Signs

Sever Cardiorespiratory Compromise ?
* Poor Perfusion
* Hypotension
* Respiratory Difficulty

* Observe
* Support ABCs
* Consider transfer or
   transport to ALS facility

No

Yes

Perform chest compressions if despite oxygenation and ventilation:
* Heart rate  < 60 / min in infant or child
   associated with poor systemic perfusion
* Start IV or Intraosseous (IO) access

Epinephrine
IV or IO :  0.01 mg / kg
ET : 0.1 mg / kg

Repeat every 3-5 min

* Minimum Single Dose :  0.1 mg
* Maximum Single Dose :  
   Child - 0.5 mg     Adolescent - 1 mg
* Maximum Total Dose :
   Child - 1 mg        Adolescent - 2 mg
* May be repeated once after 5 min

Atropine
IV or IO :  0.02 mg / kg
ET : 0.04-0.06  mg / kg

Consider External or Esophagial Pacing (*)

(*) Limited Pediatric data

Special conditions may apply
in the presence of severe Hypothermia

If Asystole develops - See Asystole Algorhythm

References: PALS ; American Heart Association / American Academy of Pediatrics. 1994 ; 7-6 - 7-11.

Paramedic Neomi Zvi - Feb 2000