Ventricular fibrillation and pulseless ventricular tachycardia

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1. Apply cardiac monitor, administer oxygen, and ventilate.

2. Perform defibrillation using 2 J/kg. Do not delay defibrillation.

3. If ventricular fibrillation persists, perform defibrillation using 4 J/kg.

4. If ventricular fibrillation persists, perform defibrillation using 4 J/kg.

5. If ventricular fibrillation persists, perform intubation, continue CPR, and obtain vascular access. Administer epinephrine, 0.1 mL/kg of 1:10,000 IV or IO (0.01 mg/kg); or 0.1 mL/kg of 1:1000 ET (0.1 mg/kg).

6. If ventricular fibrillation persists, perform defibrillation using 4 J/kg.

7. If ventricular fibrillation persists, administer lidocaine 1 mg/kg IV or IO, or 2 mg/kg ET.

8. If ventricular fibrillation persists, perform defibrillation using

9. If ventricular fibrillation persists, continue epinephrine, 0.1 mg/kg IV/IO/ET, 0.1 mL/kg of 1:1,000; administer every 3 to

5 minutes.

10. If ventricular fibrillation persists, alternate defibrillation (4 J/kg) with lidocaine and epinephrine. Consider bretylium 5 mg/kg IV first dose, 10 mg/kg IV second dose.

F. Pulseless electrical activity is uncommon in children. It usually occurs secondary to hypoxemia, hypovolemia, hypothermia, hypoglycemia, hyperkalemia, cardiac tamponade, tension pneumothorax, severe acidosis or drug overdose. Successful resuscitation depends on treatment of the underlying etiology.

1. The initial dose of IV or IO epinephrine is given in a dose of 0.1 mL/kg of the 1:10,000 concentration (0.01 mg/kg). Endotracheal epinephrine is given as a dose of 0.1 mL/kg of the 1:1,000 concentration (0.1 mg/kg) diluted to a final volume of 3-5 mL in normal saline.

2. Subsequent doses are administered every three to five minutes as 0.1 mL/kg of the 1:1,000 concentration IV/IO/ET (0.1 mg/kg).

VI.Serum glucose concentration should be determined in all children undergoing resuscitation. Glucose replacement is provided with 25% dextrose in water, 2 to 4 mL/kg (0.5 to 1 g/kg) IV over 20 to 30 minutes for hypoglycemia. In neonates, 10% dextrose in water, 5 to 10 mL/kg (0.5 to 1 g/kg), is recommended.

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  • jamila
    What are the vital signs ventricular fibrillation?
    2 years ago

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