Algorithm for Pediatric Bradycardia - Flowchart
Algorithm for Pediatric Bradycardia - Flowchart Pediatric Resuscitation Pediatric Resuscitation
«Flowchart»

Pediatric bradycardia with pulse and poor perfusion

Pediatric bradycardia with pulse and poor perfusion

Pediatric bradycardia with pulse and poor perfusion

Airway/respiration support Supplemental O2 IV/IO access, monitors

Airway/respiration support Supplemental O2 IV/IO access, monitors

Airway/respiration support Supplemental O2 IV/IO access, monitors

2

If continued:

  • Hypotension
  • Altered mental status
  • HR <60

    •

    If continued:

  • Hypotension
  • Altered mental status
  • HR <60

    •

    If continued:

  • Hypotension
  • Altered mental status
  • HR <60

  • Hypotension
  • Altered mental status
  • HR <60

    • Chest compressions

    Chest compressions

    Chest compressions

    Persistent HR <60

    Persistent HR <60

    Persistent HR <60

    End

    End

    End

    Atropine (0.02 mg/kg)b

    Atropine (0.02 mg/kg)b

    Atropine (0.02 mg/kg)b

    b b

    aMay repeat every 3 to 5 minutes. If vascular access is not available, may give 0.1 mg/kg via endotracheal tube.

    aMay repeat every 3 to 5 minutes. If vascular access is not available, may give 0.1 mg/kg via endotracheal tube.

    aMay repeat every 3 to 5 minutes. If vascular access is not available, may give 0.1 mg/kg via endotracheal tube.

    a

    bMay repeat once. Minimum atropine dose is 0.1 mg; maximum 0.5 mg. If vascular access is not available, may give 0.04 to 0.06 mg/kg atropine via ETT

    bMay repeat once. Minimum atropine dose is 0.1 mg; maximum 0.5 mg. If vascular access is not available, may give 0.04 to 0.06 mg/kg atropine via ETT

    bMay repeat once. Minimum atropine dose is 0.1 mg; maximum 0.5 mg. If vascular access is not available, may give 0.04 to 0.06 mg/kg atropine via ETT

    b

    cTranscutaneous pacing is effective for bradycardia secondary to complete heart block or sinus dysfunction associated with a congenital heart disease but is not useful for asystole or hypoxic bradycardia. If pulse is lost, proceed to pulseless arrest PALS algorithm (Figure 39.4).

    cTranscutaneous pacing is effective for bradycardia secondary to complete heart block or sinus dysfunction associated with a congenital heart disease but is not useful for asystole or hypoxic bradycardia. If pulse is lost, proceed to pulseless arrest PALS algorithm (Figure 39.4).

    cTranscutaneous pacing is effective for bradycardia secondary to complete heart block or sinus dysfunction associated with a congenital heart disease but is not useful for asystole or hypoxic bradycardia. If pulse is lost, proceed to pulseless arrest PALS algorithm (Figure 39.4).

    c (Figure 39.4). Figure 39.4

    Epinephrine (0.01 mg/kg)a

    Epinephrine (0.01 mg/kg)a

    a a Epinephrine

    ↑ Vagal tone
    1°AV block

    ↑ Vagal tone
    1°AV block

    ↑
    ↑ Vagal tone ↑

    Consider transcutaneous or transvenous pacingc

    Consider transcutaneous or transvenous pacingc

    c c Consider transcutaneous or transvenous pacing