Pediatric defibrillation doses often fail to terminate prolonged out-of-hospital ventricular fibrillation in children. #5: Drugs used in PALS (Continued) This algorithm outlines the doses and indications for the different drugs used in the treatment of children. If neither is available, an AED without a pediatric dose attenuator may be used. Lidocaine is added to to the PALS guidelines in the cardiac arrest algorithm for shock resistant VF and pVT. If the manufacturer recommended shock dose is unknown start with the maximum available dose. If adenosine is unsuccessful, proceed to synchronized cardioversion. Berg MD, Samson RA, Meyer RJ, Clark LL, Valenzuela TD, Berg RA. Because of the constant changes in defibrillator technology, it is difficult to find knowledgeable representatives who can tell you the history of defibrillator evolution. If a manual defibrillator is not available, an AED equipped with a pediatric dose attenuator is preferred. Defibrillation in PALS Guidelines. defibrillation. Medline Google Scholar; 63. Repeat every 3-5 minutes. 2b C-LD: 6. An AED is both sophisticated and easy to use, providing life-saving power in a user-friendly device. https://resources.acls.com/free-resources/videos/algorithms/ Etomidate: is indicated for the treatment of repetitive strain injury (RSI). Ensure good contact Narrow complex supraventricular tachycardia with a regular rhythm is treated with 50-100 J of synchronized cardioversion energy. PEDIATRIC ADVANCED LIFE SUPPORT DR. ... DEFIBRILLATION DOSING The recommended first energy dose for defibrillation is 2 J/kg. Apply firm pressure to paddles to create good contact between the paddle and the skin. AED with pediatric attenuator is preferred for children < 8 years of age. When using a biphasic defibrillator with VF or pulseless VT, start with the dose recommended by the manufacturer which is typically 120-200 J. PALS Medications for Cardiac Arrest and Symptomatic Arrhythmias DRUG DOSAGE (PEDIATRIC) REMARKS Adenosine Rapid Flush to central circulation 0.1 mg/kg IV/IO; (max single dose 6 mg) Second dose: 0.2 mg/kg; (maximum single dose: 12 mg) Rapid IV/IO bolus Monitor ECG during dose. Resuscitation. If this is not known, defibrillation at the maximal dose may be considered. No one knows defibrillators like MME. Adjust ENERGY button to select appropriate energy dose. 2b B-R: 5. If the first dose is unsuccessful, follow it with 0.2 mg/kg adenosine IV push to a max of 12 mg. Amiodarone for pulseless VF/VT Rapid IV bolus Every shock after the initial shock should be of equal or greater dose … For infants, a manual defibrillator is preferred to an AED for defibrillation. FOR DEFIBRILLATION First shock 2 J/kg Second shock 4 J/kg Subsequent shocks ≥4 J/kg, maximum 10 J/kg or adult dose DRUG THERAPY Epinephrine IO/IV dose:-0.01 mg/kg (0.1 mL/kg of 1:10 000 concentration). 1976; 58:898–901. Pediatrics. It is used as an infusion of 0.2–0.4 mg/kg IV/IO over a period of 30–60 seconds with a maximum dose of 20 mg. The initial dose for defibrillation in kids is 2-4J/kg and it’s not unreasonable to go higher if necessary according to our experts. This makes the device useful for people who have no experience operating an AED and allows successful use in stressful scenarios. If no IO/IV access, may give endotracheal dose… If second dose is required, it should be doubled to 4 J/kg. Call us 866-468-9558 with your questions about any defib on the market. We have been in the business for over two decades. If this dose does not terminate VF or pulseless VT, deliver subsequent doses of 4 J/kg. PALS: Pediatric advanced life support 1. If you look around the public places you visit, you are likely to find an Automated External Defibrillator (AED). If using a defibrillator capable of escalating energies, higher energy for second and subsequent shocks may be considered for presumed shock-refractory arrhythmias. Energy dose for ventricular defibrillation of children. An initial dose of 2 J/kg (biphasic or monophasic waveform) is recommended.