PULSELESS

PEDIATRIC ASSESSMENT

START CPR

GENERAL ASSESSMENT
- Check for Scene Safety
- Check for Response and Breathing
- Activate EMS or Call for Help/AED

IS THE RHYTHM SHOCKABLE?

YES

NO

PEA/ASYSTOLE

VF/PULSELESS VT

Check Pulses 5-10 sec.

Infant: Brachial
Child: Carotid

None or < 60bpm

Defibrillate

Pulses > 60bpm

2-4 J/kg
Max. of 10 J/kg

START COMPRESSIONS
At least 100 per minute
2 min. CPR

A.B.C.D.E.

1-RESCUER: 30: 2 (5 Cycles)

2-RESCUERS: 15:2 (10 Cycles)
For about 2 minutes

EPINEPHRINE
0.01 mg/kg
(0.1 mL/kg 1:10,000
Concentration)
Give every 3-5 mins.

SHOCKABLE?

PRIMARY ASSESSMENT
Airway: Keep airway patent
- Position, Suction, OPA/NPA
Breathing: Support Breathing
- Rescue Breaths: 1:3-5 sec (12-20/min)
- Cardiac Arrest with ETT: 1:6-8 sec. (8-
10/min) unsynchronized with
compressions

2 min. CPR
EPINEPHRINE
0.01 mg/kg
(0.1 mL/kg 1:10,000
Concentration)
Give every 3-5 mins.

NO

YES

Circulation: IV/IO, Monitors, Bolus,

Meds, Shock, Compress
Disability: Level of Consciousness
Exposure: Temp, Signs of Trauma

SHOCKABLE?
AED/Manual Defib
2-4 Joules/kg
Max: 10 J/kg

SECONDARY ASSESSMENT

Defibrillate
2-4 J/kg
Max. of 10 J/kg

YES

S.A.M.P.L.E.

SHOCKABLE?
NO

Signs & Symptoms, Allergies,

Medications, Past Medical History, Last
Meal/Fluids Taken, Events Leading

Evaluate

2 min. CPR
AMIODARONE
5 mg/kg IV/IO bolus
May repeat 2 times
for refractory VF/VT
d,d

2 min. CPR
x Treat Reversible
Causes
x Consider advanced
airway

By Don Frasco, RN 04-2014 Edition

Intervene

TERTIARY ASSESSMENT
Identify

Laboratory and Radiological Studies

Based on AHA 2010 PALS Guidelines