* Continue Basic CPR
* Intubation
* Ventilation with 100% Oxygen
* Obtain IV / IO access
* Connect Monitor - Recognize
   VT / VF in  more then one lead.

* The 3 shocks should be delivered rapidly
   without pausing.
* Defibrillation should not be delayed to
   achieve IV / IO access
* Adult's paddles should be used for infant
   weight more then 10 kg

Defibrillate up to 3 times if needed
* Shock 2 J/kg
* Shock 4 J/kg
* Shock 4 J/kg

Epinephrine - first dose
IV / IO :  0.01 mg / kg
ET:  0.1 mg / kg

30-60 sec. after drug administration

Shock  4 J / kg

Lidocaine
IV / IO :  1 mg / kg

30-60 sec. after drug administration

Shock  4 J / kg

Epinephrine - second dose
IV / IO / ET:  0.1 mg / kg
up to 0.2 mg / kg

Repeated every 3-5 min.

30-60 sec. after drug administration

Shock  4 J / kg

Lidocaine
IV / IO :  1 mg / kg

30-60 sec. after drug administration

Shock  4 J / kg

Bretylium - first dose
IV / IO :  5 mg / kg

30-60 sec. after drug administration

Shock  4 J / kg

Bretylium - second dose
IV / IO :  10 mg / kg

30-60 sec. after drug administration

Shock  4 J / kg

Return of Spontaneous Circulation - Consider administration of:
* Fluids - 10-20 cc / kg
* Epinephrine Drip - 0.1-0.5 mcg / kg / min
* Dopamin Drip - 10-20 mcg / kg / min
* Lidocaine Drip - 20-50 mcg / kg / min  (when ventricular arrhythmias are
   thought to be associated with myocarditis or structural heart disease

References:  PALS -
American Heart Association , American Academy of Pediatrics.  1994 ; 7-5,6  /  7-8 - 7-11  , ISBN  0-87493-635-7

Paramedic Neomi Zvi - Jan 2000