Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia

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Section 7 - PEDIATRIC / OBSTETRICAL

7.03 PEDIATRIC VENTRICULAR FIBRILLATION /PULSELESS VENTRICULAR TACHYCARDIA

  • Initiate 5 cycles of high quality (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.
  • Maintain rate of between 100-120 compressions per minute.
  • Maintain compression depth of at least 1/3 of the depth of the chest.
  • Allow for complete chest recoil between compressions.
  • Minimize interruptions
  • Assist ventilations with OXYGEN @ 100% via BVM. DO NOT HYPERVENTILATE
  • INTUBATE and establish peripheral IV or IO line as able.
  • DEFIBRILLATION @ 2 J/kg.
    • Proceed to next step only if V-Fib / Pulseless V-Tach persists.
    • If rhythm converts, follow appropriate Practice Parameters.

Refer to Handtevy System for specific medication administration based on weight / length.

  • 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 every 3 - 5 minutes of continued arrest.


  • DEFIBRILLATION @ 4 J/kg. Continue CPR immediately.
  • If rhythm converts, follow appropriate Practice Parameters.


  • If hypovolemia suspected, fluid bolus 20 ml / kg.
  • AMIODARONE 5 mg/kg, IVP or IO - refer to Broselow Tape for patient specific dose.
OR


  • DEFIBRILLATION @ 6 J/kg. Continue CPR immediately.
  • If rhythm converts, follow appropriate Practice Parameters


  • After 10 minutes, LIDOCAINE 1.0 mg/kg IV / IO.
  • DEFIBRILLATION @ 8 J/kg. Continue CPR immediately.
  • If rhythm converts, follow appropriate Practice Parameter

If V-Fib converts to a pulse-producing tachycardic rhythm, follow with LIDOCAINE boluses IVP.