PEDIATRIC CARDIAC ARREST
Cardiac dysfunction in children is more likely to respond to effective oxygenation and
ventilation than fluid administration and medications. Defibrillation alone is rarely
successful.
USE BROSELOW TAPE!
FIRST RESPONDER
1. CPR
2. Ventilate with BVM / 100% O2. Consider airway adjunct if no chest rise with BVM
3. If foreign body suspected see PINK 7-PEDIATRIC AIRWAY OBSTRUCTION
4. AED if 6 years old or above
5. Request ALS
EMT-BASIC
6. Pulse oximeter
PARAMEDIC
7. Advanced airway (consider possibility of PEDIATRIC AIRWAY OBSTRUCTION:
PINK 7)
8. Cardiac monitor / IV/IO
9. Blood glucose check. If blood glucose check <60mg in child or <40 in newborn
a. >2 years: D50W at 1ml/kg
b. <2 years: D25W at 2ml/kg
c. <1 month: D10W at 5ml/kg
d. Glucagon 1mg IM if no IV/IO
10. Treat dysrhythmias according to protocol using pediatric dosages listed below
11. If hypovolemia suspected (trauma, sepsis, dehydration, spinal injury) IV/IO bolus
of 20 ml/kg NS may be repeated a total of three times
12. Bilateral chest decompressions for traumatic arrest (GREEN 3)
13. Consider OG / NG if abdominal distention
PEDIATRIC CARDIAC ARREST DOSAGES
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
Medications:
o Atropine IV/IO 0.02 mg/kg: Minimum dose: 0.1 mg
 Maximum single dose: 1 mg
o Epinephrine IV/IO: 0.01 mg/kg (1:10,000, 0.1 ml/kg)
 ET: 0.1 mg/kg (1:1,000, 0.1 ml/kg)
 Repeat every 3-5 minutes
o Lidocaine IV/IO: 1 mg/kg
o Magnesium 25-50mg/kg IV/IO (max 2gm) for Torsades
Electricity
o Cardioversion: 0.5 J/kg (initial); 1.0 J/kg (subsequent)
o Defibrillation: 2.0 J/kg (initial); 4.0 J/kg (subsequent)
USE BROSELOW TAPE!
PINK 4