Pediatric
Post Cardiac Arrest Care

  1. Applies to pediatric patients resuscitated from cardio-respiratory arrest who have a perfusing rhythm and pulse, and who remain unresponsive.
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  3. Continue to support respirations with BVM, attempting to time support with the patients own respirations
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  5. ETCO2 should be used in line with bag during BVM. If the patient is breathing and BVM is not necessary then nasal cannula ETCO2 should be placed on the patient.
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  7. Maintain normal ventilation and oxygenation. Respiratory rate of 1 breath every 2 to 3 seconds (20-30 breaths per minute) is adequate for pediatric patients in cardiac arrest when an advanced airway is in place or if the patient is only in respiratory arrest. Target a pulse oximetry value of 94 to 99%.
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  9. Stabilize dysrhythmias:
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    1. Stable tachycardia or bradycardia – treat per protocols
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    3. If initial arrest rhythm was v-fib or v-tach, give Amiodarone 5 mg/kg (max 300 mg) IV/IO over 10 minutes if not already given during resuscitation. If significant ventricular ectopy persists, repeat amiodarone per protocol

     

  11. Support blood pressure
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    1. Administer 20 mL/kg boluses of NS to maintain adequate blood pressure for age (70 + 2xPatient Age) if post arrest rhythm is sinus tachycardia, otherwise for other cardiac rhythms use 10ml/kg NS

    2. b. If the patient’s SBP is less than lower limit based on the above equation after first bolus of fluid, call medical control for further instructions

     

  13. Obtain a 12-lead EKG.
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  15. Check glucose and treat per protocol
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  17. Seizure activity – monitor for seizure activity and treat per protocol.
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  19. Monitor for fever.