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Download Pediatric Pulseless Electrical Activity (PEA)
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CENTRAL CALIFORNIA EMERGENCY MEDICAL SERVICES A Division of the Fresno County Department of Public Health Manual Policy Number 530.35 Emergency Medical Services Administrative Policies and Procedures Page 1 of 2 Subject Paramedic Treatment Protocols PEDIATRIC PULSELESS ELECTRICAL ACTIVITY (PEA) References Effective Fresno County: 01/15/82 Kings County: 04/10/89 Madera County: 06/15/85 Tulare County: 04/19/05 Title 22, Division 9, Chapter 4 of the California Code of Regulations STANDING ORDERS 1. Assessment ABCs, CPR if appropriate. Refer to EMS Policy #549 – Initiation/Termination of CPR in the Medical Patient. 2. IV/IO Access LR TKO with Volutrol and Pediatric tubing. 3. Epinephrine IV/IO 0.01 mg/kg 1:10,000 (max dose 1mg) ET 0.1 mg/kg 1:1000 (max dose 2mg) 4. Transport 5. Intubate Continue BLS airway and consider intubation. Ventilate with bag-valve 100% oxygen. 6. Fluid Administer fluid boluses at a rate of 20 ml/kg, as needed. Reassess patient after each bolus. 7. Epinephrine 8. Contact Hospital IV/IO 0.01 mg/kg 1:10,000 (max dose 1mg)Repeat every 3-5 minutes ET 0.1 mg/kg of 1:1000 Repeat every 3-5 minutes Per EMS Policy #530.02. SPECIAL CONSIDERATIONS AND PRIORITIES 1. Consider causes: Hypovolemia Hypothermia Pneumothorax – Assess for Tension Pneumothorax Pericardial Tamponade Acidosis Hypoxia Drug Overdose 2. Refer to Broselow Tape for specific pediatric doses. Approved By Revision Signatures on File at EMS Agency EMS Division Manager 10/15/2011 Signatures on File at EMS Agency EMS Medical Director Page 2 of 2 Subject Paramedic Treatment Protocols – Pediatric Pulseless Electrical Activity (PEA) Policy Number 530.35 3. For ET medications, hold CPR during administration, follow with 2 ml Saline if dose is less than 1.5 ml, and ventilate 4 times. 4. Repeat Epinephrine every 3-5 minutes. 5. Intraosseous lines are the preferred method for rapid vascular access in the cardiac arrest in children less than 3 years of age. In children 3 years or older, attempt one peripheral line. If unsuccessful, try IO. 6. Provide family psychosocial support if resuscitation is not indicated or not successful. 7. Establish IV over ET tube if airway is secure with BLS airway. Accomplish simultaneously with other therapy if possible.
