Pediatric Pulseless Electrical Activity PEA

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Section 7 - PEDIATRIC / OBSTETRICAL

7.02 PEDIATRIC PULSELESS ELECTRICAL ACTIVITY (PEA)

CONSIDER MEDICAL ETIOLOGY OF PEA AND REFER TO APPROPRIATE PRACTICE PARAMETER:


  • Initiate 5 cycles of (30:2) one-rescuer or (15:2) two-rescuer CPR for approximately 2 minutes to allow blood to circulate and continue throughout resuscitation, minimizing interruptions. Assist ventilations with OXYGEN @ 100% via BVM. DO NOT HYPERVENTILATE
  • INTUBATE and establish peripheral IV or IO line as able.
  • If hypovolemia suspected, fluid bolus 20 ml / kg.


Refer to Handtevy System for medication administration

  • EPINEPHRINE 1:10,000 (0.1mg/ml) 0.01 mg/kg IV / IO
  • Repeat EPINEPHRINE 1:10,000 (0.1mg/ml) 0.01 mg/kg IV / IO, every 3-5 minutes of continued arrest.

If P.E.A. rate < 60 complexes per minute,

  • ATROPINE SULFATE 0.02 mg/kg, (minimum dosage is 0.1 mg)
  • REPEAT every 3-5 minutes of continued arrest for a maximum dose of 1 mg

Ventilation and oxygenation always precede drug therapy