Pediatric Dysrhythmias: VF/pulseless VT

BLS

• O2 and/or ventilate prn
• CPR
• Begin compressions, after first 30 compressions give first ventilations
• Use AED if, pulseless and unconscious, and AED is available. If pediatric pads not available may use adult pads but ensure they do not touch each other when applied

Pediatric Dysrhythmias: VF/pulseless VT

ALS

• Begin CPR

Pediatric Dysrhythmias: VF/pulseless VT

If arrest witnessed by medical personnel:

• Perform CPR until ready to defibrillate.

Pediatric Dysrhythmias: VF/pulseless VT

If unwitnessed: 

• Perform CPR x2 min

Pediatric Dysrhythmias: VF/pulseless VT

More ALS

• Defibrillate per drug chart x1
• Resume CPR for 2 minutes immediately after shock
• Perform no more than 10 second rhythm check, and pulse check if rhythm is organized
• Defibrillate per drug chart** for persistent VF/pulseless VT prn SO
• Continue CPR for persistent VF/pulseless VT. Repeat 2 minute cycle followed by rhythm/pulse check followed by defibrillation/medication, if indicated

• IV/IO SO. Do not interrupt CPR to establish IV/IO

Pediatric Dysrhythmias: VF/pulseless VT

Once IV/IO established, if no pulse after rhythm/pulse check:

• Epinephrine 1:10,000 per drug chart IV/IO. MR x2 q3-5" SO. MR q3-5" BHO.
• BVM, if unable to adequately ventilate via BVM, intubate SO
• Avoid interruption of CPR
• EtCO2 monitoring SO
• NG/OG prn SO

Pediatric Dysrhythmias: VF/pulseless VT

Note:

• For patients with an EtCO2 reading less than 10mm/Hg or patients in nonperfusing rhythms after resuscitative effort, consider early Base Hospital Contact for disposition/pronouncement at scene.
•  Medication should be administered as soon as possible after rhythm checks. The timing of drug delivery is less important than is the need to minimize interruptions in chest compressions. 
• Flush IV line with Normal Saline after medication administration 
• CPR should be performed during charging of defibrillator 

** Or according to defibrillators manufacture's recommendations