Cardiac
Chest Pain Medications
Morphine 2-10 mg (max of 10mg)
Oxygen
Nitroglycerine 0.4 mg SL (Max 1.2 mg or 3 tablets)
Aspirin 162-324 mg PO (max 324)
Acute Agitation Syndrome
Haldol 5 mg IM
Versed 5 mg IM
Benadryl 50 mg IM
Croup
albuterol 2.5 mg nebulized
epinephrine nebulized (1mg/1ml NS)
Solumedrol 2mg/kg for peds
Pediatric Seizures
Ativan: 0.05mg to 1 mg/kg IM or IN (max of 2mg)
Versed: 0.1mg/kg IM or IN (Max 2.5 mg)
Asystole/PEA
Epinephrine 1:10,000 1 mg every 3-5 minutes
Consider Hs&Ts
CHF/Pulmonary Edema
SBP greater than 90:
Nitroglycerine 0.4 mg SL
CPAP 5 peep
ASA 162-324 mg PO
Morphine 2-4 mg
Lasix 20-40 mg
Systolic less than 90:
Epinephrine 0.3mg-0.5mg IM (if shock persists consider epinephrine drip 2-10 mcg/min)
Greater than 90:
Albuterol nebulized
Epinephrine 0.3-0.5mg
Benadryl 25-50 mg IV/IM
Solu-Medrol 125 mg IV
Epiglottitis
High flow O2
Keep calm
Prepare to intubate
Pediatric Bradycardia
Severe Cardiorespiratory compromise:
begin chest compression
Epinephrine bolus 0.01mg/kg every 3-5 minutes
Atropine bolus: 0.02mg/kg may be repeated once
Consider pacing
VF/VT without a pulse
200 J then
Epinephrine 1:10,000 mg
then 300 J
then 360 J
Then Amiodarone 300 mg IVP OR Lidocaine 1.0-1.5 mg/kg IVP
Heart Failure w/ Hypotension
Dopamine 5-20 mcg/kg/min
OR
Epinephrine 2-10 mcg/min
Pregnant: Magnesium Sulfate: 2 grams IVP
Not pregnant: Ativan 2 mg (max 4 mg)
Versed 2.5 mg (Max 5 mg)
FBAO infant
5 back blows
5 chest thrusts
Open airway
Attempt to ventilate
Repeat
Ped Tachycardia with pulse
Wide QRS: Amiodarone 5mg/kg IVP over 20 min
Narrow QRS: vagals, adenosine 0.1mg/kg first dose max 6 mg, fluid challenge
IF unstable with a rate of 220 or greater for infants and 180 or greater for child: consider sedation and synchronized cardiovert at 0.5J/kg, then 1 J/kg, then 2 J/kg
Bradycardia
20 milliamps at a rate of 80 bpm confirm mechanical and electrical capture
1st dose of Atropine 1 mg bolus
TCP
Dopamine 5-20 mcg/kg/min
Epinephrine 2-10 mcg/min
Septic Shock
Fluid Challenge 10-20 ml/kg bolus
BP less than 90 systolic:
Dopamine drip 5-20 mcg/kg/min
Barbiturate/Benzo Overdose
If unresponsive: 0.2 mg slow IVP
FBAO over 1yr old
Conscious: Abdominal thrusts
Unconscious: Lay supine, open airway, if you can see it remove it, if not attempt to ventilate, if you cant perform CPR
Pediatric Arrest
Epinephrine 0.01mg/kg every 3-5 minutes
VF/VT: 2 J/Kg then 4 J/kg then 4-10 J/kg
Amiodarone 5mg/kg
CONSIDER REVERSIBLE CAUSES
Tachycardia
Stablish:
Wide QRS: Amiodarone 150 mg IVP OR Lidocaine 1.0-1.5 mg IVP
Narrow QRS: Vagals, Fluid challenge, 6 mg adenosine, the 12 mg adenosine
Hypertension
Supportive Care
Tricyclic Antidepressants
50 mEq IV drip
Supplies needed for needle cric
14 gauge
syringe
3.5 ETT adapter
BVM
Neonatal Resuscitation
HR less than 100 bpm:
PPV for 30 seconds
HR less than 60:
PPV, Chest compressions 3:1 ratio for 20 cycles
HR still less than 60:
Epi 0.01mg/kg
Consider D10 5ml/kg slow IVP
Narcan 0.1mg/kg