Pediatric Tachycardia with Pulses and Poor Perfusion Algorithm
Pediatric Tachycardia with Pulses and Poor Perfusion Algorithm - Flowchart Pediatric Tachycardia with Pulses and Poor Perfusion Algorithm Pediatric Tachycardia with Pulses and Poor Perfusion Algorithm
«Flowchart»

Start

Start

Start

9

Possible ventricular tachycardia

9

Possible ventricular tachycardia

9

9

Possible ventricular tachycardia

Possible ventricular tachycardia

8


If IO/IV access present, give adenosine
or

If IO/IV access not available, or if adenosine ineffective, synchronized cardioversion

8


If IO/IV access present, give adenosine
or

If IO/IV access not available, or if adenosine ineffective, synchronized cardioversion

8

8


If IO/IV access present, give adenosine
or

If IO/IV access not available, or if adenosine ineffective, synchronized cardioversion


If IO/IV access present, give adenosine
or

or

If IO/IV access not available, or if adenosine ineffective, synchronized cardioversion

6

Search for and treat cause

6

Search for and treat cause

6

6

Search for and treat cause

Search for and treat cause

End

End

End

11

Search for and treat cause

11

Search for and treat cause

11

11

Search for and treat cause

Search for and treat cause

12

Consider vagal maneuvers (No delays)

12

Consider vagal maneuvers (No delays)

12

12

Consider vagal maneuvers (No delays)

Consider vagal maneuvers

13

Expert consultation advised


Amiodarone
Procainamide

13

Expert consultation advised


Amiodarone
Procainamide

13

13

Expert consultation advised


Amiodarone
Procainamide


Amiodarone Amiodarone
Procainamide Procainamide

2

Evaluate QRS duration

2

Evaluate QRS duration

2

2

Evaluate QRS duration

Evaluate QRS duration

Narrow (0.09 sec)

Narrow (0.09 sec)

Narrow (0.09 sec) Narrow

Wide (>0.09 sec)

Wide (>0.09 sec)

Wide (>0.09 sec) Wide

3

Evaluate rhythm with 12-lead ECG or monitor

3

Evaluate rhythm with 12-lead ECG or monitor

3

3

Evaluate rhythm with 12-lead ECG or monitor

Evaluate rhythm with 12-lead ECG or monitor

4

Probable sinus tachycardia


Compatible history consistent with known cause
P waves present/normal
Variable R-R; constant PR
Infants: rate usually < 220/min
Children: rate usually < 180/min

4

4

Probable sinus tachycardia

Probable sinus tachycardia


Compatible history consistent with known cause
P waves present/normal
Variable R-R; constant PR
Infants: rate usually < 220/min
Children: rate usually < 180/min


Compatible history consistent with known cause
P waves present/normal
Variable R-R; constant PR
Infants: rate usually < 220/min
Children: rate usually < 180/min Probable sinus tachycardia

5

Probable supraventricular tachycardia


Compatible history (vague, nonspecific); history of abrupt rate changes
P waves absent/abnormal
HR not variable
Infants: rate usually 220/min
Children: rate usually 180/min

5

5

Probable supraventricular tachycardia

Probable supraventricular tachycardia


Compatible history (vague, nonspecific); history of abrupt rate changes
P waves absent/abnormal
HR not variable
Infants: rate usually 220/min
Children: rate usually 180/min


Compatible history (vague, nonspecific); history of abrupt rate changes
P waves absent/abnormal
HR not variable
Infants: rate usually 220/min
Children: rate usually 180/min Probable supraventricular tachycardia

10

Cardiopulmonary compromise?


Hypotension
Acutely altered mental status
Signs of shock

10

Cardiopulmonary compromise?


Hypotension
Acutely altered mental status
Signs of shock

10

10

Cardiopulmonary compromise?

Cardiopulmonary compromise?


Hypotension
Acutely altered mental status
Signs of shock


Hypotension
Acutely altered mental status
Signs of shock

YES

YES

YES YES

NO

NO

NO NO

1

Identify and treat underlying cause


Maintain patent airway; assist breathing as necessary
Oxygen
Cardiac monitor to identify rhythm; monitor blood pressure and oximetry
IO/IV access
12-lead ECG if available; do not delay therapy

1

1

Identify and treat underlying cause

Identify and treat underlying cause


Maintain patent airway; assist breathing as necessary
Oxygen
Cardiac monitor to identify rhythm; monitor blood pressure and oximetry
IO/IV access
12-lead ECG if available; do not delay therapy


Maintain patent airway; assist breathing as necessary
Oxygen
Cardiac monitor to identify rhythm; monitor blood pressure and oximetry
IO/IV access
12-lead ECG if available; do not delay therapy Identify and treat underlying cause

7

Consider vagal maneuvers (No delays)

7

7

Consider vagal maneuvers (No delays)

Consider vagal maneuvers Consider vagal maneuvers