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:
- Hypoxia / Acidosis, INITIAL MEDICAL CARE (2.01).
- Hypovolemia, SHOCK (5.13).
- Tension Pneumothorax, CHEST INJURIES (6.04).
- Hypothermia, COLD EMERGENCIES (5.06).
- 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