Pediatric Bradycardia With a Pulse and Poor Perfusion Algorithm 1 Identify and treat underlying cause • Maintain patent airway; assist breathing as necessary • Oxygen • Cardiac monitor to identify rhythm; monitor blood pressure and oximetry 1• IO/IV access...
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Pediatric Bradycardia With a Pulse and Poor Perfusion Algorithm 1 Identify and treat underlying cause • Maintain patent airway; assist breathing as necessary • Oxygen • Cardiac monitor to identify rhythm; monitor blood pressure and oximetry 1• IO/IV access • 12-Lead ECG if available; don’t delay therapy 2 Cardiopulmonary compromise? No • Hypotension • Acutely altered mental status • Signs of shock Yes 3 CPR if HR <60/min with poor perfusion despite oxygenation and ventilation 4a Doses/Details • Support ABCs Epinephrine IO/IV dose: • Give oxygen No 4 Bradycardia 0.01 mg/kg (0.1 mL/kg • Observe of 1:10 000 concentration). persists? • Consider expert Repeat every 3-5 minutes. consultation If IO/IV access not available Yes but endotracheal (ET) tube 5 in place, may give ET dose: • Epinephrine 0.1 mg/kg (0.1 mL/kg of • Atropine for increased vagal 1:1000). tone or primary AV block tropine IO/IV dose: A • Consider transthoracic pacing/ 0.02 mg/kg. May repeat once. transvenous pacing Mi
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